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NPI Code Detail

MEDICARE: BRENDA CAROL BADOUR DNP, FNP-BC

MEDICARE:   BRENDA CAROL BADOUR  DNP, FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner4704180906MI

General Provider Information

NPI Number : 1255629291
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA CAROL BADOUR DNP, FNP-BC
Provider Business Mailing Address
First Line : 1447 N HARRISON ST
Second Line :
City : SAGINAW
State : MI
Zip : 48602-4727
Country : US
Telephone Number : 989-583-4114
Fax Number : 989-583-1349
Provider Business Practice Location Address
First Line : 2919 WILDER RD STE 150
Second Line :
City : BAY CITY
State : MI
Zip : 48706-9602
Country : US
Telephone Number : 989-671-5855
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2011
Last Update Date : 09/22/2020

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Directions to “ BRENDA CAROL BADOUR DNP, FNP-BC” Practice Location

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