Provider Demographics
NPI:1962632984
Name:FELDER, BRENDA PENN (CRNP)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:PENN
Last Name:FELDER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W CUMMINGS PARK
Mailing Address - Street 2:SUITE 5000
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-6369
Mailing Address - Country:US
Mailing Address - Phone:888-763-6287
Mailing Address - Fax:888-803-6555
Practice Address - Street 1:600 W CUMMINGS PARK
Practice Address - Street 2:SUITE 5000
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-6369
Practice Address - Country:US
Practice Address - Phone:888-763-6287
Practice Address - Fax:888-803-6555
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-24
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP005995B251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management