Provider Demographics
NPI:1386344638
Name:ATHERTON, BRENDA LEE (RN)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:LEE
Last Name:ATHERTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20087 N NAVAHO TRL
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-4919
Mailing Address - Country:US
Mailing Address - Phone:832-775-6758
Mailing Address - Fax:
Practice Address - Street 1:24022 CINCO VILLAGE BLVD 120
Practice Address - Street 2:SUITE 18
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494
Practice Address - Country:US
Practice Address - Phone:832-775-6746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX681295163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse