MRS. BRENDA J LIFE CNP NPI 1073583480

NPI Information

NPI: 1073583480
Provider Name: MRS. BRENDA J LIFE, CNP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
125 E BROAD ST
SUITE 305
ELYRIA, OH
ZIP 44035
Phone: (440) 326-4120
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MRS. Brenda J Life, CNP is an adult health nurse practitioner in Elyria, OH. MRS. Brenda J Life, CNP NPI is 1073583480. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

125 E BROAD ST
SUITE 305
ELYRIA, OH
ZIP 44035-400
Phone: (440) 326-4120
Fax: (440) 322-3454

The NPI 1073583480 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 1/26/2006 and was last updated on 4/7/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	NP-00697	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	500004284	OTHER		RAILROAD MEDICARE
2	S67317	MEDICARE UPIN
3	LINP00651	MEDICARE ID-TYPE UNSPECIFIED	OHIO
4	2210744	MEDICAID	OHIO
5	000000342753	OTHER	OHIO	ANTHEM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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