Healthcare Provider Details

I. General information

NPI: 1669084034
Provider Name (Legal Business Name): JANETTE LYNN BRENNEMAN MSN, APRN, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANETTE LYNN WATSON

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5153 N 9TH AVE STE 201
PENSACOLA FL
32504-5719
US

IV. Provider business mailing address

4205 BELFORT RD STE 4015
JACKSONVILLE FL
32216-3623
US

V. Phone/Fax

Practice location:
  • Phone: 850-416-2477
  • Fax: 850-416-7520
Mailing address:
  • Phone: 904-450-6063
  • Fax: 904-539-4091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11008412
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number11008412
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: