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General NPI Number Information
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NPI Number | 1104448653
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Entity Type | Individual
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Provider Name | BRIAN PATRICK BERENDTS APRN-CNP
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Gender | Male
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Dates
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Enumeration Date | 05/07/2020
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Last Update Date | 07/27/2020
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Provider Practice Location Address
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Address Line | 3333 BURNET AVE ML3014 PSYCHIATRY
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City | CINCINNATI
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State | OH
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Zip | 45229-3026
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Country | US
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Telephone | 513-636-4788
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Fax | 513-636-4283
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Provider Business Mailing Address
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Address Line | MEDICAL STAFF SERVICES 3333 BURNET AVE., MLC 5021
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City | CINCINNATI
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State | OH
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Zip | 45229
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Country | US
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Telephone | 513-636-5278
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Fax | 513-636-2511
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.0026891
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License Number State | OH
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