Healthcare Provider Details

I. General information

NPI: 1265550545
Provider Name (Legal Business Name): KATHLEEN M BREHM R.N., B.S.N.,MSN,FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 04/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 UNIVERSITY DR LEHIGH UNIV HEALTH CENTER
BETHLEHEM PA
18015-3062
US

IV. Provider business mailing address

2337 HOLLOW VIEW DR
EASTON PA
18040-7564
US

V. Phone/Fax

Practice location:
  • Phone: 610-758-4055
  • Fax:
Mailing address:
  • Phone: 805-573-4671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number650904
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP012524
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF337026
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ0035160
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number21106
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: