Provider Demographics
NPI:1225180078
Name:HOLLANDER, BRENDA S (CRNA)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:S
Last Name:HOLLANDER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 HOFFMAN DR
Mailing Address - Street 2:STE A
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-4297
Mailing Address - Country:US
Mailing Address - Phone:970-667-9794
Mailing Address - Fax:970-663-6336
Practice Address - Street 1:5721 W 119TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-3722
Practice Address - Country:US
Practice Address - Phone:816-763-5446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS55564367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200423420AMedicaid
MO914588207Medicaid
COCOAAA1841Medicare UPIN
MO914588207Medicaid