Provider Demographics
NPI:1861647976
Name:NATE AARON BRENNAN
Entity Type:Organization
Organization Name:NATE AARON BRENNAN
Other - Org Name:BRENNANS FOOT AND ANKLE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRENNAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:423-286-7850
Mailing Address - Street 1:20463 ALBERTA ST
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841-3509
Mailing Address - Country:US
Mailing Address - Phone:423-286-7850
Mailing Address - Fax:423-286-7851
Practice Address - Street 1:20463 ALBERTA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-3509
Practice Address - Country:US
Practice Address - Phone:423-286-7850
Practice Address - Fax:423-286-7851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM0000000627213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6168570001Medicare NSC