Provider Demographics
NPI:1083991301
Name:HERMEN, BRENNA T (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRENNA
Middle Name:T
Last Name:HERMEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11299 GLENMOOR CIR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-3156
Mailing Address - Country:US
Mailing Address - Phone:623-680-4800
Mailing Address - Fax:
Practice Address - Street 1:15700 E BRIARWOOD CIR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-1558
Practice Address - Country:US
Practice Address - Phone:720-214-6001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19156183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist