Individual
MRS. JENNIFER NICOLE BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
112 MEDICAL VILLAGE DR STE G, WALLACE, NC 28466-1665
(910) 552-1580
Mailing address
104 PAGODA CT, HAMPSTEAD, NC 28443-7252
(571) 643-3195
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5017058
NC
Other
Enumeration date
10/10/2022
Last updated
10/18/2022
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