Provider Demographics
NPI:1972532257
Name:BRENNAN, MAUREEN THERESE (CRNA)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:THERESE
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 MARGUERITE RD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-2445
Mailing Address - Country:US
Mailing Address - Phone:504-736-9862
Mailing Address - Fax:504-736-9862
Practice Address - Street 1:401 MARGUERITE RD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003-2445
Practice Address - Country:US
Practice Address - Phone:504-736-9862
Practice Address - Fax:504-736-9862
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN039189367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered