Individual
BRENDA MAXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
56 MARKET ST, POTSDAM, NY 13676-1747
(315) 256-4065
Mailing address
9 BALMAT FOWLER RD, GOUVERNEUR, NY 13642-3351
(315) 287-7697
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
232836-1
NY
Other
Enumeration date
02/26/2016
Last updated
02/26/2016
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