Individual
BRENNA CHRISTINE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1111 W 34TH ST, SUITE 200, AUSTIN, TX 78705
(512) 324-3405
(512) 458-5446
Mailing address
1111 W 34TH ST, SUITE 200, AUSTIN, TX 78705
(512) 279-6749
(512) 298-1795
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP131507
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376643801
—
TX
Enumeration date
06/01/2016
Last updated
09/25/2023
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