Provider Demographics
NPI:1477523017
Name:PARTLOW, BRENDA J L (NP)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:J L
Last Name:PARTLOW
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:JEAN
Other - Last Name:LEONHARDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:200 1ST ST SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55905-0001
Mailing Address - Country:US
Mailing Address - Phone:507-284-2511
Mailing Address - Fax:
Practice Address - Street 1:200 1ST ST SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905-0001
Practice Address - Country:US
Practice Address - Phone:507-284-2511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1326084363L00000X
AZAP2338363L00000X
AZRN104757363L00000X
MN0114363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNP01045283OtherRAILROAD MEDICARE
AZ995665Medicaid
AZP00287058OtherRAILROAD MEDICARE
AZZ107574Medicare PIN
MN500007287Medicare PIN
AZP00287058OtherRAILROAD MEDICARE