1578752614

Everything you always wanted to know about BECKER W. BRENNA NP 1 BECKER W. BRENNA NP but were afraid to ask.

BECKER W. BRENNA NP 1 BECKER W. BRENNA NP

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Provider Last Name Provider Middle Name Provider First Name Provider Credential Provider Other Name Type Code Provider Other Last Name Provider Other Middle Name Provider Other First Name Provider Other Credential
BECKER W. BRENNA NP 1 BECKER W. BRENNA NP
Gender:
Female
Enumeration date:
2007-10-15
Last update date:
2017-09-14
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state
000402902 Medicare PIN none MA
0723673 Medicaid none MA

Taxonomies

Taxonomy State License Number Primary?
363LF0000X Family UT 9811085-4405 Y
363L00000X Nurse Practitioner MA RN266912 N

Phone Numbers

Type Number
Practice Location Address Telephone Number 8015813834
Mailing Address Telephone Number (508) 864-5012

Addresses

Type Address City State Postal Country
Mailing Address 2738 E PEBBLE GLEN CIR SALT LAKE CITY UT 84109 UT
Practice Location Address 675 S ARAPEEN DR # DR205 SALT LAKE CITY UT 0 UT

Other NPI Records that share a phone number

NPI Name Address State City
1093239428 BECK, MOLLY
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675 S ARAPEEN DR UT SALT LAKE CITY
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30 N 1900 E UT SALT LAKE CITY
1407815863 KEYE, WILLIAM
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1518057116 JONES, KIRTLY
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1700976305 HUANG, IVAN
Individual
50 N MEDICAL DR UT SALT LAKE CITY