Healthcare Provider Details

I. General information

NPI: 1437584034
Provider Name (Legal Business Name): BRENDA KLEE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRENDA BASSETT

II. Dates (important events)

Enumeration Date: 09/13/2013
Last Update Date: 09/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 COMMERCIAL BLVD
LAUDERDALE BY THE SEA FL
33308-4442
US

IV. Provider business mailing address

265 COMMERCIAL BLVD
LAUDERDALE BY THE SEA FL
33308-4442
US

V. Phone/Fax

Practice location:
  • Phone: 954-772-3960
  • Fax: 954-772-3981
Mailing address:
  • Phone: 954-772-3960
  • Fax: 954-772-3981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number9239048
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP9239048
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: