MEDICARE: BRENDA S DEESER CNP

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
1	363L00000X	Nurse Practitioner	COA.08623-NP	OH
2	363LW0102X	Women's Health Nurse Practitioner	COA.08623-NP	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437337474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA S DEESER CNP

Provider Business Mailing Address
First Line	:	21 E STATE ST OFC 233
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-4281
Country	:	US
Telephone Number	:	888-731-8994
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 E STATE ST OFC 233
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-4281
Country	:	US
Telephone Number	:	888-731-8994
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2008
Last Update Date	:	09/02/2025

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