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Mrs. Brenda J Life, CNP
Adult Health Nurse Practitioner in Elyria, Ohio
NPI 1073583480

Brenda J Life is an Adult Health Nurse Practitioner based in Avon, OH and is specialized in Adult Health. Brenda J Life practices in Elyria, OH and has the professional credentials of CNP. The NPI Number for Brenda J Life is 1073583480 and holds a License No. NP-00697 (Ohio).

The current practice location address for Brenda J Life is 125 E Broad St, Elyria, OH and can be reached out via phone at 440-326-4120 and via fax at 440-322-3454.

Location: 125 E Broad St, Elyria, OH, 44011-4044
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073583480
Provider Name
Brenda J Life
Credential
CNP
Provider Entity Type
Individual
Gender
Female
Address
125 E Broad St, Elyria, OH, 44011-4044
Phone Number
440-326-4120
Fax Number
440-322-3454
Provider Enumeration Date
01/26/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000342753 01 OH ANTHEM
2210744 05 OH
500004284 01 RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
125 E Broad St
City
Elyria
State
Ohio
Zip
44035-6400
Phone Number
440-326-4120
Fax Number
440-322-3454
person
Provider Business Mailing Address Details
Address
125 E Broad St
City
Elyria
State
Ohio
Zip
44035-6400
Phone Number
440-326-4120
Fax Number
440-322-3454
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
363LA2200X
License No.
NP-00697 (Ohio)
Definition
Definition to come...
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