MEDICARE: BRENDA MARGARET GIFFEN APRN

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	ARNP2540422	FL
2	363L00000X	Nurse Practitioner	APRN2540422	FL

General Provider Information

NPI Number	:	1639142839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA MARGARET GIFFEN APRN

Provider Business Mailing Address
First Line	:	4377 WHISTLEWOOD CIR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33811-3049
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4377 WHISTLEWOOD CIR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33811-3049
Country	:	US
Telephone Number	:	863-648-9573
Fax Number	:

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	11/23/2022

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