Provider Demographics
NPI:1710601802
Name:EKPERI, BRENDA N (APRN, ACNPC-AG)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:N
Last Name:EKPERI
Suffix:
Gender:F
Credentials:APRN, ACNPC-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1136 NEWPARK VIEW PL
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-7235
Mailing Address - Country:US
Mailing Address - Phone:404-519-5243
Mailing Address - Fax:
Practice Address - Street 1:1136 NEWPARK VIEW PL
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-7235
Practice Address - Country:US
Practice Address - Phone:404-519-5243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN213914363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner