Provider Demographics
NPI:1942275581
Name:MCCARTHY, BRENDA L (FNP-C)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:L
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9411 N OAK TRFY STE LL1
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2262
Mailing Address - Country:US
Mailing Address - Phone:816-691-1655
Mailing Address - Fax:512-827-0928
Practice Address - Street 1:2790 CLAY EDWARDS DR STE 520
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3274
Practice Address - Country:US
Practice Address - Phone:816-221-6750
Practice Address - Fax:816-221-7280
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9235876363L00000X
TX1044201363L00000X
MO91423363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR084062Medicare PIN
FLOTH000Medicare UPIN