Individual
MRS. MICHELLE LYNN BRENEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
100 BREVCO PLZ, STE 101, LAKE SAINT LOUIS, MO 63367-1382
(636) 561-5437
(636) 561-5100
Mailing address
PO BOX 7412119, CHICAGO, IL 60674-2119
(636) 561-5437
(636) 561-5100
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2003020311
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420041212
—
MO
Enumeration date
04/17/2008
Last updated
04/18/2025
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