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:
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Health care specialties

SpecialtyCodeLicense #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 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073583480 NPPES
Ohio Other 000000342753 ANTHEM
Ohio MEDICAID 2210744 ANTHEM
Ohio Other 500004284 ANTHEM

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