Provider Demographics
NPI:1467078220
Name:DRENNAN, SCOTT (APRN)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:DRENNAN
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 POPPS FERRY RD STE A3
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-2226
Mailing Address - Country:US
Mailing Address - Phone:228-232-0890
Mailing Address - Fax:228-232-0891
Practice Address - Street 1:1600 BROAD AVE
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-3603
Practice Address - Country:US
Practice Address - Phone:228-213-5888
Practice Address - Fax:228-573-3433
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS903963363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health