MEDICARE: MRS. BRENDA JEAN DRENNEN APRN

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
1	363LF0000X	Family Nurse Practitioner	3003258	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255313821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRENDA JEAN DRENNEN APRN

Provider Business Mailing Address
First Line	:	129 STONE TRACE DR
Second Line	:
City	:	MT STERLING
State	:	KY
Zip	:	40353-9386
Country	:	US
Telephone Number	:	859-498-6006
Fax Number	:	859-498-8006

Provider Business Practice Location Address
First Line	:	644 MAYSVILLE RD
Second Line	:	STE 8
City	:	MT STERLING
State	:	KY
Zip	:	40353-9464
Country	:	US
Telephone Number	:	859-498-6006
Fax Number	:	859-498-8006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	05/03/2018

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