Provider Demographics
NPI:1972506129
Name:CARRIER, BRENDA J (CRNP)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:J
Last Name:CARRIER
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 1:333 STATE ST
Mailing Address - Street 2:STE 204
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1466
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:333 STATE ST
Practice Address - Street 2:STE 204
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1466
Practice Address - Country:US
Practice Address - Phone:814-454-8886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP005767B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA069323Medicare PIN
PAP88015Medicare UPIN