Provider Demographics
NPI:1184181349
Name:BRENDING, BEVERLY TERESA (ELECTROLOGIST)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:TERESA
Last Name:BRENDING
Suffix:
Gender:F
Credentials:ELECTROLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 GRAND AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-3384
Mailing Address - Country:US
Mailing Address - Phone:651-642-1374
Mailing Address - Fax:
Practice Address - Street 1:745 GRAND AVE STE 101
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-3384
Practice Address - Country:US
Practice Address - Phone:651-642-1374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist