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General NPI Number Information
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NPI Number | 1245219898
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Entity Type | Individual
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Provider Name | BRENDA BISHOP AZAR FNP
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Gender | Female
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 04/21/2017
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Provider Practice Location Address
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Address Line | 2 COLLEGE ST
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City | PROVIDENCE
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State | RI
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Zip | 02903-2717
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Country | US
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Telephone | 401-454-6625
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Fax | 401-454-6628
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Provider Business Mailing Address
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Address Line | 123 EVANS AVE
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City | TIVERTON
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State | RI
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Zip | 02878-4327
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Country | US
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Telephone | 401-439-0915
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Fax | 401-816-5962
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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 | NPP33078
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN161430
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License Number State | MA
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