Individual
KEVIN FRANCIS BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
218 STONE ST, WATERTOWN, NY 13601
(315) 782-7400
(315) 782-7460
Mailing address
RED LAKE HOSPITAL, PO BOX 497, HIGHWAY 1, RED LAKE, MN 56671
(218) 679-3912
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
32 320050
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
807
STATE LICENSE
AK
Enumeration date
10/02/2006
Last updated
08/30/2011
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