Individual
LISA JOSEPHINE BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1851 W END AVE, POTTSVILLE, PA 17901-2050
(570) 628-2611
Mailing address
10 EASTWOOD LN, POTTSVILLE, PA 17901-1440
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN260692L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016256630001
—
PA
Enumeration date
03/13/2007
Last updated
07/08/2007
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