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General NPI Number Information
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NPI Number | 1295708634
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Entity Type | Individual
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Provider Name | BRENDA L ABERCROMBIE FNP, CNM
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Gender | Female
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 05/08/2009
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Provider Practice Location Address
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Address Line | 12329 S HIGHWAY 39
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City | STOCKTON
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State | MO
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Zip | 65785-8580
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Country | US
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Telephone | 417-276-4663
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Fax | 636-600-5260
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Provider Business Mailing Address
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Address Line | 12329 S HIGHWAY 39
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City | STOCKTON
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State | MO
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Zip | 65785-8580
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Country | US
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Telephone | 417-276-4663
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Fax | 636-600-5260
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 129233
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License Number State | MO
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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 | 129223
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 129223
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License Number State | MO
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