Individual
BRENNEN PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1060 KEMPSVILLE RD APT 7305, NORFOLK, VA 23502-2754
(757) 383-2706
Mailing address
600 GRESHAM DR, NORFOLK, VA 23507-1904
(757) 388-8000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001330003
VA
Other
Enumeration date
10/16/2024
Last updated
10/16/2024
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