Provider Demographics
NPI:1790418960
Name:PATEL, BRINDA (NP)
Entity Type:Individual
Prefix:
First Name:BRINDA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9847 W WHITE FEATHER LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-2928
Mailing Address - Country:US
Mailing Address - Phone:928-899-3270
Mailing Address - Fax:
Practice Address - Street 1:9847 W WHITE FEATHER LN
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-2928
Practice Address - Country:US
Practice Address - Phone:928-899-3270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ269862363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner