Provider Demographics
NPI:1689031148
Name:OSTERHUS, BRENDA RUTH (RN IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:RUTH
Last Name:OSTERHUS
Suffix:
Gender:F
Credentials:RN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9081 NUGENT TRL
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-6325
Mailing Address - Country:US
Mailing Address - Phone:919-279-3551
Mailing Address - Fax:
Practice Address - Street 1:9081 NUGENT TRL
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-6325
Practice Address - Country:US
Practice Address - Phone:919-279-3551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-27
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAL-28684163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant