Individual
BRENDA DALE FASONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN-INACTIVE LICENSE
Contact information
Practice address
14108 WAINWRIGHT CT, BOWIE, MD 20715-1738
(301) 875-9532
(301) 262-5158
Mailing address
14108 WAINWRIGHT CT, BOWIE, MD 20715-1738
(301) 875-9532
(301) 262-5158
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
11/26/2024
Last updated
11/26/2024
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