Provider Demographics
NPI:1255313821
Name:DRENNEN, BRENDA JEAN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:JEAN
Last Name:DRENNEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:129 STONE TRACE DR
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-9386
Mailing Address - Country:US
Mailing Address - Phone:859-498-6006
Mailing Address - Fax:859-498-8006
Practice Address - Street 1:644 MAYSVILLE RD
Practice Address - Street 2:STE 8
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-9464
Practice Address - Country:US
Practice Address - Phone:859-498-6006
Practice Address - Fax:859-498-8006
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3003258363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78007275Medicaid
KY735901Medicare ID - Type Unspecified
KYP24679Medicare UPIN