Individual
MRS. THALIA JEANNE BRENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN,ARNP-BC
Contact information
Practice address
1 MINNI TOHE DR, NEW TOWN, ND 58763-4400
(800) 465-3203
Mailing address
PO BOX 56967, NORTH POLE, AK 99705-1967
(917) 363-9387
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
105961
AK
171000000X
Military Health Care Provider
105961
CO
363LF0000X
Family Nurse Practitioner
Primary
105961
CO
Other
Enumeration date
01/24/2006
Last updated
11/05/2010
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