Provider Demographics
NPI:1013692706
Name:JORENBY, BRANWEN (PA-S)
Entity Type:Individual
Prefix:
First Name:BRANWEN
Middle Name:
Last Name:JORENBY
Suffix:
Gender:F
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5743 RUSSETT RD APT 1B
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-3488
Mailing Address - Country:US
Mailing Address - Phone:612-380-6185
Mailing Address - Fax:
Practice Address - Street 1:5743 RUSSETT RD APT 1B
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-3488
Practice Address - Country:US
Practice Address - Phone:612-380-6185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program