Provider Demographics
NPI:1780083055
Name:HOZIE, BRENDA LYNN (DPT)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:LYNN
Last Name:HOZIE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:LYNN
Other - Last Name:BOLDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:3405 NW HUNTERS RIDGE TER
Practice Address - Street 2:STE 300
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66618-2509
Practice Address - Country:US
Practice Address - Phone:785-246-2300
Practice Address - Fax:785-246-2301
Is Sole Proprietor?:No
Enumeration Date:2014-08-22
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-04854225100000X
MO2015003001225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
51071018OtherBCBS-KC
003332OtherOPTUM
KSKA2868062OtherMEDICARE PTAN
KSUSES NPIOtherBCBS-KANSAS