Individual
BREANNA LYNNAE PUCCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11211 HILL CREST LN, MARENGO, IL 60152-8257
(224) 539-7249
Mailing address
11211 HILL CREST LN, MARENGO, IL 60152-8257
(224) 539-7249
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041496642
IL
163W00000X
Registered Nurse
108848030
WI
Other
Enumeration date
04/07/2025
Last updated
04/07/2025
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