Individual
NICHOLE BRENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5694 S SARAH JANE DR, KEARNS, UT 84118-7549
(531) 213-9883
Mailing address
5694 S SARAH JANE DR, KEARNS, UT 84118-7549
(531) 213-9883
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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