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NPI Code Detail

MEDICARE: STACY H BRENNAN

MEDICARE: STACY H BRENNAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1246XC2901XCardiovascular Invasive Specialist/Technologist74852CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1003175OTHERKAISER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1093858557
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY H BRENNAN
Provider Business Mailing Address
First Line : 4027 S WISTERIA WAY
Second Line :
City : DENVER
State : CO
Zip : 80237-1713
Country : US
Telephone Number : 720-493-1959
Fax Number :
Provider Business Practice Location Address
First Line : 2045 FRANKLIN ST
Second Line :
City : DENVER
State : CO
Zip : 80205-5437
Country : US
Telephone Number : 303-764-4523
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2007
Last Update Date : 07/08/2007

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Directions to “ STACY H BRENNAN ” Practice Location

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