Provider Demographics
NPI:1720383698
Name:HOCKENBERRY, BRENDA RENEA (LPN)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:RENEA
Last Name:HOCKENBERRY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 THE MEADOWS DRIVE
Mailing Address - Street 2:
Mailing Address - City:CENTRE HALL
Mailing Address - State:PA
Mailing Address - Zip Code:16828
Mailing Address - Country:US
Mailing Address - Phone:814-364-2161
Mailing Address - Fax:
Practice Address - Street 1:132 THE MEADOWS DR
Practice Address - Street 2:
Practice Address - City:CENTRE HALL
Practice Address - State:PA
Practice Address - Zip Code:16828-9231
Practice Address - Country:US
Practice Address - Phone:814-364-2161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN261150L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse