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NPI Code Detail

MEDICARE: BROOKE ANN BRENNING PA-C, RD

MEDICARE: BROOKE ANN BRENNING PA-C, RD
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
1133V00000XRegistered Dietitian
2363A00000XPhysician AssistantPA2025-0142NM

General Provider Information

NPI Number : 1780330308
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE ANN BRENNING PA-C, RD
Provider Business Mailing Address
First Line : 2516 SUMMER SAGE DR SW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87121-8747
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4701 MONTGOMERY BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87109-1219
Country : US
Telephone Number : 505-727-7022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2022
Last Update Date : 12/17/2025

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