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Individual

MS. BRENDA KAY CLARKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
1301 MEMORIAL DR, BRYAN, TX 77802-5205
(979) 731-4520
(979) 731-4570
Mailing address
1500 UNIVERSITY DR E, SUITE 100, COLLEGE STATION, TX 77840-2600
(979) 846-1100
(979) 260-9390

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
240095
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1497183883
ST. JOSEPH HEALTH POINT BRYAN - FACILITY NPI
01
74-1715140
BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.
TX
Enumeration date
09/16/2013
Last updated
11/21/2013
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