Provider Demographics
NPI:1295996494
Name:STOUDT, BRENDA M (ARNP)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:M
Last Name:STOUDT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9705 W NELSON DR
Mailing Address - Street 2:
Mailing Address - City:NINE MILE FALLS
Mailing Address - State:WA
Mailing Address - Zip Code:99026-8651
Mailing Address - Country:US
Mailing Address - Phone:509-230-3914
Mailing Address - Fax:509-464-6959
Practice Address - Street 1:1717 W FRANCIS AVE STE 104
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6858
Practice Address - Country:US
Practice Address - Phone:509-230-3914
Practice Address - Fax:509-464-6959
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2024-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WA30007859208000000X
WAAP30007859363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No208000000XAllopathic & Osteopathic PhysiciansPediatrics