Provider Demographics
NPI:1376106997
Name:REED, BRENNA KATHERINE HALLUM (DPM)
Entity Type:Individual
Prefix:
First Name:BRENNA
Middle Name:KATHERINE HALLUM
Last Name:REED
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5156 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2424
Mailing Address - Country:US
Mailing Address - Phone:614-702-7655
Mailing Address - Fax:614-706-1770
Practice Address - Street 1:5156 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-2424
Practice Address - Country:US
Practice Address - Phone:614-702-7655
Practice Address - Fax:614-706-1770
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-18
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36004066213E00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist