Provider Demographics
NPI:1881949857
Name:POINDEXTER, BRENDA (RN)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:POINDEXTER
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 1:1403 MONTERRA PT
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-2027
Mailing Address - Country:US
Mailing Address - Phone:281-248-6728
Mailing Address - Fax:
Practice Address - Street 1:1403 MONTERRA PT
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-2027
Practice Address - Country:US
Practice Address - Phone:281-431-4182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX690040163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse