Individual
BRENDA RENEE MAHAFFEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
411 S PINE ST, DERIDDER, LA 70634-4839
(337) 462-6070
Mailing address
411 S PINE ST, DERIDDER, LA 70634-4839
(337) 221-2990
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
222899
LA
363LP2300X
Primary Care Nurse Practitioner
Primary
222899
LA
Other
Enumeration date
12/27/2021
Last updated
08/31/2022
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