Provider Demographics
NPI:1427002880
Name:DEMINT, BRENDA E (RN, CRNA)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:E
Last Name:DEMINT
Suffix:
Gender:F
Credentials:RN, CRNA
Other - Prefix:MISS
Other - First Name:BRENDA
Other - Middle Name:E
Other - Last Name:O'BRIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CRNA
Mailing Address - Street 1:13900 WESTGATE ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-2896
Mailing Address - Country:US
Mailing Address - Phone:913-515-9906
Mailing Address - Fax:913-232-9247
Practice Address - Street 1:13900 WESTGATE ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66221-2896
Practice Address - Country:US
Practice Address - Phone:913-515-9906
Practice Address - Fax:913-232-9247
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2014-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1356583072163W00000X
KS54714367500000X
MO115806163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOW49000005Medicare PIN
KSW499332BMedicare PIN
KS00S36037OtherPREFERRED HEALTH SYSTEMS
MO23394083OtherBLUE CROSS BLUE SHIELD KANSAS CITY
KS180055004Medicare PIN
MOW49A00003Medicare PIN