Individual
MRS. BRENDA J NESMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4284 KELSON AVE, MARIANNA, FL 32446-2948
(850) 482-2910
(850) 482-2836
Mailing address
4284 KELSON AVE, MARIANNA, FL 32446-2948
(850) 482-2910
(850) 482-2836
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1903262
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305751800
—
FL
01
—
E6998X
MEDICARE
—
01
—
P00129958
MEDICARE RAILROAD
—
01
—
Y4506
BLUECROSS BLUE SHIELD FLORIDA
FL
Enumeration date
01/18/2007
Last updated
08/20/2015
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