Provider Demographics
NPI:1821789991
Name:MURRIN ANDERSON, BRENNA A (LAC)
Entity Type:Individual
Prefix:MS
First Name:BRENNA
Middle Name:A
Last Name:MURRIN ANDERSON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 S STATE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3777
Mailing Address - Country:US
Mailing Address - Phone:978-761-4201
Mailing Address - Fax:
Practice Address - Street 1:17 S STATE ST APT 3
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3777
Practice Address - Country:US
Practice Address - Phone:978-761-4201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAC798171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist