Provider Demographics
NPI:1578937967
Name:STOOPS, BRENDA (NP-C)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:STOOPS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 GARFIELD AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-3247
Mailing Address - Country:US
Mailing Address - Phone:304-865-3600
Mailing Address - Fax:
Practice Address - Street 1:1212 GARFIELD AVE STE 202
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3247
Practice Address - Country:US
Practice Address - Phone:681-229-3058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-23
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV60122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily