Individual
BRENDA LEE NOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6451 VILLAGE LN, MACUNGIE, PA 18062-8484
(610) 967-2772
(610) 967-2559
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 822-4355
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
OA000712
PA
363AM0700X
Medical Physician Assistant
Primary
MA003454L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114212
MC PTAN
PA
Enumeration date
06/23/2006
Last updated
03/03/2022
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