Provider Demographics
NPI:1104448653
Name:BERENDTS, BRIAN PATRICK (APRN-CNP)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:PATRICK
Last Name:BERENDTS
Suffix:
Gender:M
Credentials:APRN-CNP
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Other - Middle Name:
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Mailing Address - Street 1:MEDICAL STAFF SERVICES
Mailing Address - Street 2:3333 BURNET AVE., MLC 5021
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229
Mailing Address - Country:US
Mailing Address - Phone:513-636-5278
Mailing Address - Fax:513-636-2511
Practice Address - Street 1:3333 BURNET AVE ML3014
Practice Address - Street 2:PSYCHIATRY
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4788
Practice Address - Fax:513-636-4283
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-07
Last Update Date:2020-07-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0026891363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty