Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | PENDING | TX |
NPI | 1194358358 |
---|---|
Provider Name | Ashley Lynn Brenner |
First Address | Houston, TX 77046-0207 |
Second Address | Houston, TX 77030-2608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2020 |
Last Update Date | 17/02/2020 |