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General NPI Number Information
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NPI Number | 1700373420
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Entity Type | Individual
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Provider Name | BRENNA GERDEMAN
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Gender | Female
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Dates
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Enumeration Date | 04/18/2018
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 65 HIGHVIEW BLVD
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City | COLUMBUS
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State | OH
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Zip | 43207-6056
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Country | US
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Telephone | 614-850-7450
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Fax |
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Provider Business Mailing Address
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Address Line | 65 HIGHVIEW BLVD
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City | COLUMBUS
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State | OH
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Zip | 43207-6056
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | RN.404382
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | F08180665
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License Number State | OH
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