Provider Demographics
NPI:1013912310
Name:BRENNER, JAMES N (GNP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:N
Last Name:BRENNER
Suffix:
Gender:M
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 WHITE BRIDGE RD
Mailing Address - Street 2:SUITE 103-243
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-1444
Mailing Address - Country:US
Mailing Address - Phone:615-673-6737
Mailing Address - Fax:800-474-4039
Practice Address - Street 1:73 WHITE BRIDGE RD
Practice Address - Street 2:SUITE 103-243
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-1444
Practice Address - Country:US
Practice Address - Phone:615-673-6737
Practice Address - Fax:800-474-4039
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN110225363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN410-1956OtherBCBS
3908255Medicare ID - Type Unspecified
TN410-1956OtherBCBS