Provider Demographics
NPI:1417405457
Name:BRENNAN, KENNETH J (PHARM D)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:J
Last Name:BRENNAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 HIGLAND AVE, 1530
Mailing Address - Street 2:UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53792
Mailing Address - Country:US
Mailing Address - Phone:608-263-1290
Mailing Address - Fax:608-263-9424
Practice Address - Street 1:600 HIGLAND AVE
Practice Address - Street 2:UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792
Practice Address - Country:US
Practice Address - Phone:608-263-1290
Practice Address - Fax:608-263-9424
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17911-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist