MEDICARE: BRENDA BRIEN 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	363LF0000X	Family Nurse Practitioner	RN116712 NP02298	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	500028844	OTHER		RAILROAD MEDICARE

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	:	1598762502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA BRIEN CNP

Provider Business Mailing Address
First Line	:	4235 SECOR RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43623-4231
Country	:	US
Telephone Number	:	419-691-4235
Fax Number	:

Provider Business Practice Location Address
First Line	:	2751 BAY PARK DR
Second Line	:
City	:	OREGON
State	:	OH
Zip	:	43616-4921
Country	:	US
Telephone Number	:	419-691-4235
Fax Number	:

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	06/20/2011

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Directions to “ BRENDA BRIEN CNP” Practice Location

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