Individual
BRENDA MARIE EDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3810
(217) 422-6100
(217) 422-3217
Mailing address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3810
(217) 422-6100
(217) 422-3217
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
209006509
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01054366
RAILROAD
IL
Enumeration date
05/12/2009
Last updated
03/12/2013
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