Provider Demographics
NPI:1023262946
Name:MARCY, BRENDA LYNN (FNP-BC)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:LYNN
Last Name:MARCY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 EASTRIDGE CTR
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-3410
Mailing Address - Country:US
Mailing Address - Phone:715-838-7372
Mailing Address - Fax:715-838-2910
Practice Address - Street 1:2240 EASTRIDGE CTR
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-3410
Practice Address - Country:US
Practice Address - Phone:715-838-7372
Practice Address - Fax:715-838-2910
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3552-033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily