Provider Demographics
NPI:1710877428
Name:HUSHER, BREN LYNDELL (ESTHETICIAN)
Entity type:Individual
Prefix:
First Name:BREN
Middle Name:LYNDELL
Last Name:HUSHER
Suffix:
Gender:F
Credentials:ESTHETICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 LIMA ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-2528
Mailing Address - Country:US
Mailing Address - Phone:408-310-2213
Mailing Address - Fax:
Practice Address - Street 1:1620 LIMA ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-2528
Practice Address - Country:US
Practice Address - Phone:408-310-2213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-04
Last Update Date:2025-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCOZ.60010933747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant