Provider Demographics
NPI:1881756732
Name:SOWARDS, BRENDA N (ARNP)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:N
Last Name:SOWARDS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 N 7TH ST STE 375
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2707
Mailing Address - Country:US
Mailing Address - Phone:602-307-0070
Mailing Address - Fax:602-307-0080
Practice Address - Street 1:1331 N 7TH ST STE 375
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2707
Practice Address - Country:US
Practice Address - Phone:602-307-0070
Practice Address - Fax:602-307-0080
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00096096363L00000X
WAAP30007497363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q74904Medicare UPIN