Provider Demographics
NPI:1821086364
Name:ZIEGLER, BRENDA HUITT (RN-FNP)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:HUITT
Last Name:ZIEGLER
Suffix:
Gender:F
Credentials:RN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 BRYANT IRVIN RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4029
Mailing Address - Country:US
Mailing Address - Phone:817-263-2500
Mailing Address - Fax:
Practice Address - Street 1:5701 BRYANT IRVIN RD
Practice Address - Street 2:SUITE 201
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4029
Practice Address - Country:US
Practice Address - Phone:817-263-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX557944363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111947107Medicaid
TXP00744160OtherRR MEDICARE PTAN
TX111947108Medicaid
TXP00744160OtherRR MEDICARE PTAN
TX530517Medicare UPIN
TX8C9929Medicare ID - Type UnspecifiedMEDICARE NUMBER
TX111947108Medicaid