Provider Demographics
NPI:1366405599
Name:SPRINKLE, BRENDA BRANNON (PA-C)
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:BRANNON
Last Name:SPRINKLE
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:148 STONERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHESNEE
Mailing Address - State:SC
Mailing Address - Zip Code:29323-9560
Mailing Address - Country:US
Mailing Address - Phone:864-580-0471
Mailing Address - Fax:
Practice Address - Street 1:1529 N LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29340-4737
Practice Address - Country:US
Practice Address - Phone:864-488-1283
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ16534Medicare UPIN