Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | CNM06401 | NC |
NPI | 1063024503 |
---|---|
Provider Name | Mrs. Kandyce S. Brennan |
First Address | Durham, NC 27705-4699 |
Second Address | Durham, NC 27705-4699 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2020 |
Last Update Date | 17/08/2020 |