Individual
CAROLINE BRAGG BRENNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1139 LEXINGTON AVE, SAVANNAH, GA 31404-5502
(912) 303-4200
(912) 790-2701
Mailing address
1139 LEXINGTON AVE, SAVANNAH, GA 31404-5502
(912) 303-4200
(912) 790-2701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004781
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202I975559
MEDICARE PTAN
GA
Enumeration date
11/13/2006
Last updated
03/07/2023
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