Provider Demographics
NPI:1497498190
Name:CARNEY, BRENDA L (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:L
Last Name:CARNEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 GLEN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-3782
Mailing Address - Country:US
Mailing Address - Phone:865-567-4337
Mailing Address - Fax:
Practice Address - Street 1:406 GLEN OAKS DR
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37615-3782
Practice Address - Country:US
Practice Address - Phone:865-567-4337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29798363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily