Provider Demographics
NPI:1104514892
Name:BRENT, EMILY NICOLE (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:NICOLE
Last Name:BRENT
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 SW MARTIN DR STE B
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66609-1221
Mailing Address - Country:US
Mailing Address - Phone:877-942-2239
Mailing Address - Fax:
Practice Address - Street 1:601 SW CORPORATE VW STE 100
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615-1245
Practice Address - Country:US
Practice Address - Phone:785-295-8877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-82714-031363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily