Individual
BRENDA LEE BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
401 N WOODLAWN ST, WELLINGTON, KS 67152-2857
(620) 326-3556
(620) 892-5843
Mailing address
401 N WOODLAWN ST, WELLINGTON, KS 67152-2857
(620) 326-3556
(620) 892-5843
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
BO96011
KS
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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