Individual
MS. MARY J BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Contact information
Practice address
10 ANDOVER RD, PORTLAND, ME 04102-1954
(207) 761-6642
Mailing address
10 ANDOVER RD, PORTLAND, ME 04102-1954
(207) 761-6642
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
047934-23
NH
363LA2100X
Acute Care Nurse Practitioner
047934-23
NH
363LA2100X
Acute Care Nurse Practitioner
Primary
CNP211468
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30347119
—
NH
05
—
432951999
—
ME
Enumeration date
08/02/2006
Last updated
12/21/2021
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