Provider Demographics
NPI:1396075552
Name:CORREA, BRENDA (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:
Last Name:CORREA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 W FLOYD AVE APT 311
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80236-6012
Mailing Address - Country:US
Mailing Address - Phone:720-261-7217
Mailing Address - Fax:
Practice Address - Street 1:541 NORFOLK ST STE 100
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-9348
Practice Address - Country:US
Practice Address - Phone:720-847-6049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-10
Last Update Date:2010-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17501183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist