Provider Demographics
NPI:1548391535
Name:THOMAS, BRENDA SCOTT (WHNP)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:SCOTT
Last Name:THOMAS
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3418 REBEH RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38109-3436
Mailing Address - Country:US
Mailing Address - Phone:901-785-5638
Mailing Address - Fax:
Practice Address - Street 1:6000 STATE RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-7628
Practice Address - Country:US
Practice Address - Phone:901-531-1856
Practice Address - Fax:901-373-8127
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000005267363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health