Provider Demographics
NPI:1780847731
Name:BRENNAN, EWA L (RN,MSN,ANP,C)
Entity Type:Individual
Prefix:MRS
First Name:EWA
Middle Name:L
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:RN,MSN,ANP,C
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Mailing Address - Street 1:10777 SUNSET OFFICE DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-1019
Mailing Address - Country:US
Mailing Address - Phone:314-822-5900
Mailing Address - Fax:314-822-5919
Practice Address - Street 1:1031 BELLEVUE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1818
Practice Address - Country:US
Practice Address - Phone:314-644-6300
Practice Address - Fax:314-644-2503
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2009-09-02
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Provider Licenses
StateLicense IDTaxonomies
MO2001030526363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO137300003Medicare PIN