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General NPI Number Information
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NPI Number | 1881503092
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Entity Type | Individual
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Provider Name | BRENNEN DOUGLAS BARNES CPHT
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Gender | Male
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 1979 LIME KILN RD
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City | BELLEVUE
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State | WI
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Zip | 54311-6219
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Country | US
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Telephone | 920-288-0638
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Fax |
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Provider Business Mailing Address
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Address Line | 2214 TRELLIS RIDGE LN APT 3
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City | DE PERE
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State | WI
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Zip | 54115-4513
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Country | US
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Telephone | 920-639-3994
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 232526-41
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License Number State | WI
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