Healthcare Provider Details

I. General information

NPI: 1790595148
Provider Name (Legal Business Name): BRENNA REICHMAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 S STATE ST STE 215
ANN ARBOR MI
48104-7103
US

IV. Provider business mailing address

2735 SEQUOIA PKWY
ANN ARBOR MI
48103-2663
US

V. Phone/Fax

Practice location:
  • Phone: 734-547-3990
  • Fax: 734-547-3980
Mailing address:
  • Phone: 510-599-3935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRENNA REICHMAN
Title or Position: NURSE PRACTITIONER
Credential: MSN, RN, AGNP-C
Phone: 510-599-3935