Provider Demographics
NPI:1972771467
Name:LOUD, BRENDA (NP)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:LOUD
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:CARDIOVASCULAR CONSULTANTS OF CAPE COD LLC
Mailing Address - Street 2:140 YARMOUTH ROAD
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601
Mailing Address - Country:US
Mailing Address - Phone:508-778-8818
Mailing Address - Fax:507-778-1003
Practice Address - Street 1:140 YARMOUTH RD
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3064
Practice Address - Country:US
Practice Address - Phone:508-778-8818
Practice Address - Fax:508-778-1003
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA150670163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse