Individual
BRENDA K CLEMENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1326 MALABAR RD SE STE 3, PALM BAY, FL 32907-2502
(321) 409-6100
(321) 409-6063
Mailing address
1326 MALABAR RD SE STE 3, PALM BAY, FL 32907-2502
(321) 409-6100
(321) 409-6063
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001942A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IT764Z
MEDICARE
FL
Enumeration date
05/16/2006
Last updated
11/04/2017
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