Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 0000000000000 | IN |
Y | 363LA2100X | Nurse Practitioner - Acute Care | 28176470A | IN |
NPI | 1023682002 |
---|---|
Provider Name | Jennifer Erin Brenner |
First Address | Owensboro, KY 42303-1449 |
Second Address | Owensboro, KY 42303-1449 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2021 |
Last Update Date | 14/05/2021 |