Provider Demographics
NPI:1508026295
Name:STAPP, BRENNA C (DO)
Entity Type:Individual
Prefix:DR
First Name:BRENNA
Middle Name:C
Last Name:STAPP
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:BRENNA
Other - Middle Name:
Other - Last Name:CORBETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:150 TARRYTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103
Mailing Address - Country:US
Mailing Address - Phone:603-622-3162
Mailing Address - Fax:603-622-8677
Practice Address - Street 1:150 TARRYTOWN ROAD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103
Practice Address - Country:US
Practice Address - Phone:603-622-3162
Practice Address - Fax:603-622-8677
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH15680207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology