Provider Demographics
NPI:1134569775
Name:BRENNAN-LYNCH, JANNA KAY (RN)
Entity type:Individual
Prefix:MRS
First Name:JANNA
Middle Name:KAY
Last Name:BRENNAN-LYNCH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13193 CENTRAL AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-4179
Mailing Address - Country:US
Mailing Address - Phone:909-591-0843
Mailing Address - Fax:909-591-7226
Practice Address - Street 1:13193 CENTRAL AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-4179
Practice Address - Country:US
Practice Address - Phone:909-591-0843
Practice Address - Fax:909-591-7226
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA549465163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA549465OtherLICENSE FOR NURSING