Rena Lynn Bryson

Individual provider Active NPI General Practice Registered Nurse · Peru, IN

NPI 1861187684 · NPPES record last updated Apr 7, 2023

Key facts

NPI
1861187684
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Registered Nurse 163WG0000X
License
28183938A (IN)
Practice address
1496 W Hoosier Blvd
Peru, IN 46970-3727
Phone
(765) 472-8907
Fax
(765) 677-5175
NPI assigned
Apr 7, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
28183938AINMDGeneral Practice Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 28183938A IN Yes

Addresses

Primary practice location

1496 W Hoosier Blvd
Peru, IN 46970-3727

Mailing address

1496 W Hoosier Blvd
Peru, IN 46970-3727
Phone (765) 472-8907

Other providers in Peru, IN

All providers in Peru, IN · General Practice Registered Nurse in Indiana

Sources for this page

Verify at the official NPI Registry.