| Doctor Name: | LACEY B BRENNER |
| NPI Number: | 1508162710 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | OD |
| License Number: | OEG002404 |
| Business Practice Address: | 250 Max Dr Suite 101 Castle Pines, CO - 801089517 |
| Business Phone Number: | 3036885066 |
| Business Fax Number: | 3036886986 |
| Mailing Address: | 5850 Roy Hts, COLORADO SPRINGS |
| State: | CO |
| Postal Code: | 809181593 |
| Phone Number: | 7858210499 |
| Fax Number: | |
| NPI Enumeration Date: | 02/04/2011 |
| NPI Last Update Date: | 05/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | OEG002404 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |