Provider Demographics
NPI:1003996265
Name:DAY, BRENDA E (CLINICAL NURSE SPECI)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:E
Last Name:DAY
Suffix:
Gender:F
Credentials:CLINICAL NURSE SPECI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 BAYRIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-3100
Mailing Address - Country:US
Mailing Address - Phone:601-956-3732
Mailing Address - Fax:
Practice Address - Street 1:1500 WOODROW WILSON BLVD EAST
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216
Practice Address - Country:US
Practice Address - Phone:601-362-4471
Practice Address - Fax:601-364-1298
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1015886163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
1015886Medicare UPIN