Healthcare Provider Details

I. General information

NPI: 1972771467
Provider Name (Legal Business Name): BRENDA LOUD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 12/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 YARMOUTH RD
HYANNIS MA
02601-3064
US

IV. Provider business mailing address

CARDIOVASCULAR CONSULTANTS OF CAPE COD LLC 140 YARMOUTH ROAD
HYANNIS MA
02601
US

V. Phone/Fax

Practice location:
  • Phone: 508-778-8818
  • Fax: 508-778-1003
Mailing address:
  • Phone: 508-778-8818
  • Fax: 507-778-1003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number150670
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: