Healthcare Provider Details

I. General information

NPI: 1588164263
Provider Name (Legal Business Name): ADRIENNE ALEXANDRA BRENNER AG-CNSBC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2018
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 RADAM LN
AUSTIN TX
78745-1172
US

IV. Provider business mailing address

8240 N MOPAC EXPY STE 100
AUSTIN TX
78759-8869
US

V. Phone/Fax

Practice location:
  • Phone: 512-443-5988
  • Fax: 512-443-5055
Mailing address:
  • Phone: 512-687-1970
  • Fax: 512-407-9010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberAP135584
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: