Provider Demographics
NPI:1740307875
Name:FOGLEMAN, BRENDA KAY (RN)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:KAY
Last Name:FOGLEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 WINDWARD LN
Mailing Address - Street 2:
Mailing Address - City:SODDY DAISY
Mailing Address - State:TN
Mailing Address - Zip Code:37379-8260
Mailing Address - Country:US
Mailing Address - Phone:423-332-7548
Mailing Address - Fax:
Practice Address - Street 1:9527 W RIDGE TRAIL RD
Practice Address - Street 2:
Practice Address - City:SODDY DAISY
Practice Address - State:TN
Practice Address - Zip Code:37379-4018
Practice Address - Country:US
Practice Address - Phone:423-842-3031
Practice Address - Fax:423-842-5353
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000043050163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health