Individual provider Active NPI

Amy Brender, RN

  • Registered Nurse
  • Pearl Harbor, HI
National Provider Identifier
1356768808
Registry record updated Mar 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
572706 Issued in CA
Practice address
480 Central Ave
Pearl Harbor, HI 96860-4908
Phone
(808) 471-1866
NPI assigned
Mar 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 572706 CA Primary

Addresses

Primary practice location

480 Central Ave
Pearl Harbor, HI 96860-4908

Mailing address

PO Box 875
Hauula, HI 96717-0875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
572706CAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395446400000",
    "number": "1356768808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 875",
            "city": "HAUULA",
            "state": "HI",
            "postal_code": "967170875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 CENTRAL AVE",
            "city": "PEARL HARBOR",
            "state": "HI",
            "postal_code": "968604908",
            "telephone_number": "808-471-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENDER",
        "first_name": "AMY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-22",
        "last_updated": "2014-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "572706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl Harbor, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.