Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN.CNP.0029949 | OH |
NPI | 1467919316 |
---|---|
Provider Name | Brian J. Brenner |
First Address | Toledo, OH 43606-3895 |
Second Address | Toledo, OH 43606-3895 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2019 |
Last Update Date | 12/10/2021 |