Healthcare Provider Details

I. General information

NPI: 1225466733
Provider Name (Legal Business Name): SHAWNA BRENNFLECK NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2013
Last Update Date: 10/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LOWER NAVY HILL ROAD
SAIPAN MP
96950
US

IV. Provider business mailing address

5173 CURRY RD
PITTSBURGH PA
15236-2541
US

V. Phone/Fax

Practice location:
  • Phone: 670-234-8950
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024171243
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: