Provider Demographics
NPI:1629311204
Name:OWUSU, BRENDA (DNP, ANP-BC, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:
Last Name:OWUSU
Suffix:
Gender:F
Credentials:DNP, ANP-BC, FNP-BC
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:
Other - Last Name:MINNIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:32019 RED TAIL BLVD
Mailing Address - Street 2:
Mailing Address - City:SORRENTO
Mailing Address - State:FL
Mailing Address - Zip Code:32776-7763
Mailing Address - Country:US
Mailing Address - Phone:850-766-0451
Mailing Address - Fax:
Practice Address - Street 1:4932 SW 167TH AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4908
Practice Address - Country:US
Practice Address - Phone:850-766-0451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN3316472363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health