Doctor Name: | BROOKE BRENNAN |
NPI Number: | 1417294786 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 31339 N Blackfoot Dr San Tan Valley, AZ - 851434945 |
Business Phone Number: | 4802159446 |
Business Fax Number: | |
Mailing Address: | 31339 N Blackfoot Dr, SAN TAN VALLEY |
State: | AZ |
Postal Code: | 851434945 |
Phone Number: | 4802159446 |
Fax Number: | |
NPI Enumeration Date: | 01/07/2013 |
NPI Last Update Date: | 01/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |