Individual
BRENNA EARNEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 PIN OAK LN, KEYSER, WV 26726-5908
(304) 597-3774
(304) 597-3536
Mailing address
100 PIN OAK LN, KEYSER, WV 26726-5908
(304) 597-3774
(304) 597-3536
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
50860
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21410126
DIABETIC EDUCATOR
WV
Enumeration date
09/10/2014
Last updated
09/10/2014
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