Individual
MS. BRENDA MICHELLE THEILEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
21 CHESTERTON CT, BLUFFTON, SC 29910-7332
(843) 949-8388
Mailing address
21 CHESTERTON CT, BLUFFTON, SC 29910-7332
(843) 949-8388
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
135188
MO
363L00000X
Nurse Practitioner
17635A
SC
363L00000X
Nurse Practitioner
RN229112
GA
Other
Enumeration date
07/14/2006
Last updated
01/17/2020
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