Individual
BRENDA KAY DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
201 S LLOYD ST, SUITE E201, ABERDEEN, SD 57401-4552
(605) 622-2545
(605) 622-2531
Mailing address
PO BOX 1460, ABERDEEN, SD 57402-1460
(605) 622-2545
(605) 622-2531
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CP000401
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19897
—
ND
01
—
255183
MIDLANDS CHOICE
SD
01
—
340071053796
PREFERRED ONE
SD
01
—
4992470
WELLMARK BC/BS OF SD
SD
05
—
6829900
—
SD
01
—
9240654
DAKOTACARE
SD
Enumeration date
03/01/2007
Last updated
11/12/2008
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