1366703696 NPI number — MRS. BRENDA LEE BYRD APRN, FNP-C

Table of content: MRS. BRENDA LEE BYRD APRN, FNP-C (NPI 1366703696)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366703696 NPI number — MRS. BRENDA LEE BYRD APRN, FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BYRD
Provider First Name:
BRENDA
Provider Middle Name:
LEE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN, FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RITCHIE
Provider Other First Name:
BRENDA
Provider Other Middle Name:
LEE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP-C
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1366703696
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
915 TATE BLVD SE STE 186
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HICKORY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28602-4042
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-303-2131
Provider Business Mailing Address Fax Number:
828-304-0943

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
915 TATE BLVD SE STE 186
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HICKORY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28602-4042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-303-2131
Provider Business Practice Location Address Fax Number:
828-324-0253
Provider Enumeration Date:
06/04/2012

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: 363LF0000X , with the licence number:  3007452 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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