| Doctor Name: | MS. MARY JAYNE BRENNAN |
| NPI Number: | 1164424628 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 762192 |
| Business Practice Address: | 12955 Palms West Dr Ste 100 Building 8 Loxahatchee, FL - 334704993 |
| Business Phone Number: | 5617982468 |
| Business Fax Number: | 5617982733 |
| Mailing Address: | 8200 S Jog Rd, Suite 203 BOYNTON BEACH |
| State: | FL |
| Postal Code: | 334722981 |
| Phone Number: | 5613274960 |
| Fax Number: | 5617381807 |
| NPI Enumeration Date: | 08/15/2005 |
| NPI Last Update Date: | 09/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 762192 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |