Provider Demographics
NPI:1356005888
Name:BRENNAN, MONICA TERESA (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:TERESA
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4727 E BETTY ELYSE LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-3337
Mailing Address - Country:US
Mailing Address - Phone:507-513-3236
Mailing Address - Fax:
Practice Address - Street 1:10617 N HAYDEN RD STE B102
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-5685
Practice Address - Country:US
Practice Address - Phone:480-483-9011
Practice Address - Fax:480-483-2803
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-30
Last Update Date:2021-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ264151207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty