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Individual

LAURA LYNN BRENNECKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4399
(215) 590-3630
Mailing address
409 SECOND AVE, SUITE 303, COLLEGEVILLE, PA 19426-3625
(610) 409-8050

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
SP015549
PA

Other

Enumeration date
10/27/2015
Last updated
11/14/2019
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