Individual
MS. DEENA R BRISSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1811 CHARLTON CT, GOSHEN, IN 46526-6464
(574) 534-8200
(574) 534-0411
Mailing address
1811 CHARLTON CT, GOSHEN, IN 46526-6464
(574) 534-8200
(574) 534-0411
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
622215
TX
363LF0000X
Family Nurse Practitioner
Primary
71001310A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180329801
—
TX
Enumeration date
10/03/2006
Last updated
07/22/2022
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