Provider Demographics
NPI:1720612211
Name:BRENEMAN, LINDSEY (RN)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:
Last Name:BRENEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 KALAPUYA CT
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97424-1325
Mailing Address - Country:US
Mailing Address - Phone:812-202-9586
Mailing Address - Fax:
Practice Address - Street 1:10 COBURG RD STE 100
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7479
Practice Address - Country:US
Practice Address - Phone:541-868-9700
Practice Address - Fax:651-868-4814
Is Sole Proprietor?:No
Enumeration Date:2020-02-24
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLC-LC10228395163WL0100X
OR202000886RN163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant