Provider Demographics
NPI:1205946431
Name:KARGEL, BRENDA L (NP)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:L
Last Name:KARGEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8383 ORA LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HALE
Mailing Address - State:MI
Mailing Address - Zip Code:48739-8904
Mailing Address - Country:US
Mailing Address - Phone:989-728-5649
Mailing Address - Fax:
Practice Address - Street 1:1020 ALMIRA ST.
Practice Address - Street 2:COVENANT HEALTH CARE
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602
Practice Address - Country:US
Practice Address - Phone:989-583-4228
Practice Address - Fax:989-583-4882
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704093455363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily