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General NPI Number Information
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NPI Number | 1861142374
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Entity Type | Individual
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Provider Name | HAYLEY LAWRENCE BRENNAN DO
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Gender | Female
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Dates
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Enumeration Date | 03/27/2022
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 590 W RIDGE RD STE J
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City | WYTHEVILLE
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State | VA
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Zip | 24382-1067
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Country | US
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Telephone | 276-228-2405
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Fax |
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Provider Business Mailing Address
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Address Line | 590 W RIDGE RD STE J
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City | WYTHEVILLE
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State | VA
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Zip | 24382-1067
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Country | US
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Telephone | 276-228-2405
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Fax | 833-941-2005
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0102209349
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License Number State | VA
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