Brenda G St. Clair, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

L42004 Issued in AR

Practice address

490 Broadmoor Dr
Brinkley, AR 72021-2057

Phone

(870) 734-3202

Fax

(870) 734-3299

NPI assigned

Jun 4, 2019

Last updated

Jun 4, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1760040885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 BROWNS LN",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017213",
            "telephone_number": "870-972-4939",
            "fax_number": "870-972-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 BROADMOOR DR",
            "city": "BRINKLEY",
            "state": "AR",
            "postal_code": "720212057",
            "telephone_number": "870-734-3202",
            "fax_number": "870-734-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. CLAIR",
        "first_name": "BRENDA",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AR",
            "license": "L42004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simmons Eye Center
• Johnathan Clyde Simpson, LCSW
• Southern Lifecare Emergency Medical Services, Inc.
• Southern Paramedic Service Inc
• Heather Deann Spoon, APN
• State of Arkansas (Monroe County Health Unit)
• State of Arkansas (Arkansas Department of Health Hospice 9W)
• Candice M Stewart
• Stuttgart Regional Medical Center (Brinkley Medical Clinic)
• Superintendent of Brinkley High School

• Licensed Practical Nurse in Brinkley, AR
• Providers in Brinkley, AR by specialty
• Licensed Practical Nurse in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.