Individual
BRENTON A HALLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1520 4TH ST, LEWISPORT, KY 42351-2529
(270) 295-3890
Mailing address
PO BOX 1099, OWENSBORO, KY 42302-1099
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3013698
KY
363L00000X
Nurse Practitioner
71011067A
IN
363LF0000X
Family Nurse Practitioner
Primary
3013698
KY
Other
Enumeration date
08/13/2019
Last updated
05/07/2021
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