Provider Demographics
NPI:1770627960
Name:HOLBERT-FERNANDEZ, BRENDA LOUISE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:LOUISE
Last Name:HOLBERT-FERNANDEZ
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1201 W FRANK AVE
Mailing Address - Street 2:TEMPLE CANCER CENTER
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3357
Mailing Address - Country:US
Mailing Address - Phone:936-639-7466
Mailing Address - Fax:936-639-7472
Practice Address - Street 1:1201 W FRANK AVE
Practice Address - Street 2:TEMPLE CANCER CENTER
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3357
Practice Address - Country:US
Practice Address - Phone:936-639-7466
Practice Address - Fax:936-639-7472
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX581785363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily