Provider Demographics
NPI:1700207586
Name:SPIES, BRENDA RENEE (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:RENEE
Last Name:SPIES
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4252 OSAGE BEACH PKWY
Mailing Address - Street 2:
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065-2171
Mailing Address - Country:US
Mailing Address - Phone:573-348-4095
Mailing Address - Fax:573-348-9264
Practice Address - Street 1:4252 OSAGE BEACH PARKWAY
Practice Address - Street 2:
Practice Address - City:OSAGE BEACH
Practice Address - State:MO
Practice Address - Zip Code:65065
Practice Address - Country:US
Practice Address - Phone:573-348-4095
Practice Address - Fax:573-348-9264
Is Sole Proprietor?:No
Enumeration Date:2013-12-23
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO045224183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist