Provider Demographics
NPI:1295344232
Name:PEARSON, BRENDA JEAN (CRNP-PMH)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:JEAN
Last Name:PEARSON
Suffix:
Gender:F
Credentials:CRNP-PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 ALEXANDER BELL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2105
Mailing Address - Country:US
Mailing Address - Phone:410-646-8874
Mailing Address - Fax:949-561-4249
Practice Address - Street 1:6700 ALEXANDER BELL DR STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2105
Practice Address - Country:US
Practice Address - Phone:410-646-8874
Practice Address - Fax:949-561-4249
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-27
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR180976363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health