Life, Brenda J
Life, Brenda J is an individual health care provider with primary practice located at 125 E Broad St Suite 305, Elyria OH 44035-6400. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Life, Brenda J can be contacted via phone (440) 326-4120.Contact Information
Primary practice address
125 E Broad St Suite 305
Elyria OH 44035-6400
Phone: (440) 326-4120
Fax: (440) 322-3454
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | NP-00697 | Ohio |
Profile Details
NPI number | 1073583480 |
---|---|
LBN Legal business name | Life, Brenda J |
Credentials | Certified Nurse Practitioner (CNP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 26th, 2006 |
Last updated | Apr 7th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1073583480 | NPPES |
Ohio | Other | 000000342753 | ANTHEM |
Ohio | MEDICAID | 2210744 | ANTHEM |
Ohio | Other | 500004284 | ANTHEM |
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