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General NPI Number Information
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NPI Number | 1699579938
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Entity Type | Individual
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Provider Name | BRENDA LEE BRENT PHARMD
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Gender | Female
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 1223 S GEAR AVE STE 109
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City | WEST BURLINGTON
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State | IA
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Zip | 52655-1685
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Country | US
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Telephone | 319-768-1820
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Fax |
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Provider Business Mailing Address
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Address Line | 1874 E STATE HIGHWAY 164
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City | KIRKWOOD
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State | IL
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Zip | 61447-9705
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Country | US
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Telephone | 319-759-2418
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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 | 1835C0206X
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Taxonomy Name | Cardiology Pharmacist
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License Number | 18730
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License Number State | IA
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