Individual
MR. TIMOTHY PETER BRENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PPCNP-BC
Contact information
Practice address
480 CENTRAL AVE BLDG 1750, JBPHH, HI 96860-4908
(808) 471-5171
Mailing address
480 CENTRAL AVE BLDG 1750, JBPHH, HI 96860-4908
(088) 471-5171
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
18189
CA
363LP0200X
Pediatric Nurse Practitioner
RN572397
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18189
NURSE PRACTITIONER CERTIFICATE
CA
01
—
572394
REGISTERED NURSE LICENSE
CA
Enumeration date
07/09/2008
Last updated
11/01/2022
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