Individual
THERESA MARIE BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-1607
(319) 356-4552
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-1607
(319) 356-4552
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
30434
IA
207RC0000X
Cardiovascular Disease Physician
Primary
30434
IA
207RI0011X
Interventional Cardiology Physician
30434
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0130765
—
IA
01
—
52299
WELLMARK BCBS
IA
Enumeration date
10/07/2005
Last updated
01/18/2019
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