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Individual
REBEKAH B. BRENNAN
Active
Individual
REBEKAH B. BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1003
SC
363A00000X
Physician Assistant
Primary
MA054628
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0316PA
—
SC
01
—
576007863077
BCBS OF SC ID
SC
Enumeration date
05/08/2006
Last updated
01/15/2021
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