Provider Demographics
NPI:1235202920
Name:LIMA, BRENDA (PHMCNS, BC)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:
Last Name:LIMA
Suffix:
Gender:F
Credentials:PHMCNS, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 CLIFF DR
Mailing Address - Street 2:
Mailing Address - City:ASSONET
Mailing Address - State:MA
Mailing Address - Zip Code:02702-1377
Mailing Address - Country:US
Mailing Address - Phone:508-644-9884
Mailing Address - Fax:
Practice Address - Street 1:1 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3960
Practice Address - Country:US
Practice Address - Phone:508-828-9116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA147252363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health