1336121755 NPI number — DR. BRENDA LEE HOSKINS-MEIN ARNP

Table of content: DR. BRENDA LEE HOSKINS-MEIN ARNP (NPI 1336121755)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336121755 NPI number — DR. BRENDA LEE HOSKINS-MEIN ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOSKINS-MEIN
Provider First Name:
BRENDA
Provider Middle Name:
LEE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOSKINS
Provider Other First Name:
BRENDA
Provider Other Middle Name:
LEE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DNP, ARNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1336121755
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 KALISA WAY STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARAMUS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07652-3508
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-948-6789
Provider Business Mailing Address Fax Number:
877-345-3501

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 HAWKINS DR
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PSYCHIATRY
Provider Business Practice Location Address City Name:
IOWA CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52242-1009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-356-4654
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/20/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LG0600X , with the licence number:  J-087279 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: J-087279 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0434381 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0445023 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".