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Individual

BRENDA L LEVERENZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1217 KEARNEY ST, SUITE 1, PORT HURON, MI 48060-3571
(810) 982-2095
(810) 982-8513
Mailing address
1217 KEARNEY ST, SUITE 1, PORT HURON, MI 48060-3571
(810) 982-2095
(810) 982-8513

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003344
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00221152
PALMETTO RAILROAD MEDICARE
Enumeration date
02/28/2006
Last updated
08/15/2012
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