| Doctor Name: | TIERNEY BRENNAN |
| NPI Number: | 1831553023 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 209014087 |
| Business Practice Address: | 464 Inveraray Rd Villanova, PA - 190851138 |
| Business Phone Number: | 6306401167 |
| Business Fax Number: | |
| Mailing Address: | 464 Inveraray Rd, VILLANOVA |
| State: | PA |
| Postal Code: | 190851138 |
| Phone Number: | 6306401167 |
| Fax Number: | |
| NPI Enumeration Date: | 04/13/2016 |
| NPI Last Update Date: | 04/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 209014087 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |