Provider Demographics
NPI:1609189034
Name:BRENCHLEY, CYNTHIA LOU SEWELL (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LOU SEWELL
Last Name:BRENCHLEY
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 W COLORADO BLVD
Mailing Address - Street 2:STE 525
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-2312
Mailing Address - Country:US
Mailing Address - Phone:214-960-5681
Mailing Address - Fax:214-960-5681
Practice Address - Street 1:221 W COLORADO BLVD. PAVILION II SUITE 800
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208
Practice Address - Country:US
Practice Address - Phone:214-960-5681
Practice Address - Fax:214-947-2727
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2017-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX708964363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX285587603Medicaid
TX285587601Medicaid
TX285587602Medicaid
TX285587603Medicaid
TXTXB138991Medicare PIN
TXTXB138993Medicare PIN