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General NPI Number Information
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NPI Number | 1205185758
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Entity Type | Individual
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Provider Name | BRENDA NYAMBWEKE FNP
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Gender | Female
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Dates
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Enumeration Date | 08/30/2012
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Last Update Date | 06/30/2015
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Provider Practice Location Address
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Address Line | 8840 BENBROOK BLVD
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City | BENBROOK
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State | TX
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Zip | 76126-3440
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Country | US
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Telephone | 682-233-6832
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Fax | 817-249-7375
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Provider Business Mailing Address
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Address Line | 1023 PARVIEW CIR
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City | CEDAR HILL
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State | TX
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Zip | 75104-6900
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Country | US
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Telephone |
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28182685A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 836250
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License Number State | TX
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