Individual
MS. PENELOPE ANN BRENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
520 GLENWOOD ST, BOSSIER CITY, LA 71111-2205
(318) 747-3344
Mailing address
520 GLENWOOD ST, BOSSIER CITY, LA 71111-2205
(318) 747-3344
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN022405 AP01926
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1905348
—
LA
Enumeration date
08/28/2007
Last updated
08/28/2007
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