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NPI Code Detail

MEDICARE: MRS. BRENDA S BRENNAN APRN

MEDICARE: MRS. BRENDA S BRENNAN 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
1363LC1500XCommunity Health Nurse Practitioner44376KS

General Provider Information

NPI Number : 1619979440
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRENDA S BRENNAN APRN
Provider Business Mailing Address
First Line : PO BOX 1832
Second Line :
City : PITTSBURG
State : KS
Zip : 66762-1832
Country : US
Telephone Number : 620-231-9873
Fax Number : 620-231-2808
Provider Business Practice Location Address
First Line : 3011 N MICHIGAN ST
Second Line :
City : PITTSBURG
State : KS
Zip : 66762-2546
Country : US
Telephone Number : 620-231-9873
Fax Number : 620-231-2808
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 12/08/2021

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