Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | R70715 | AZ |
NPI | 1003140443 |
---|---|
Provider Name | Dr. Brenna Katherine Yursik |
First Address | Scottsdale, AZ 85267-5070 |
Second Address | Page, AZ 86040-1447 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2009 |
Last Update Date | 25/02/2015 |