Provider Demographics
NPI:1336121755
Name:HOSKINS-MEIN, BRENDA LEE (ARNP)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:LEE
Last Name:HOSKINS-MEIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:LEE
Other - Last Name:HOSKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, ARNP
Mailing Address - Street 1:1 KALISA WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3508
Mailing Address - Country:US
Mailing Address - Phone:888-948-6789
Mailing Address - Fax:877-345-3501
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-4654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-20
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAJ-087279363LG0600X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0434381Medicaid
IA0445023Medicaid
IAI12549Medicare ID - Type UnspecifiedGROUP
IA0445023Medicaid
IA0434381Medicaid