Provider Demographics
NPI:1780847731
Name:BRENNAN, EWA L (RN,MSN,ANP,C)
Entity type:Individual
Prefix:MRS
First Name:EWA
Middle Name:L
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:RN,MSN,ANP,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 LAWNDALE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-1885
Mailing Address - Country:US
Mailing Address - Phone:336-543-0786
Mailing Address - Fax:336-234-5411
Practice Address - Street 1:4125 LAWNDALE DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-1885
Practice Address - Country:US
Practice Address - Phone:336-543-0786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001030526363L00000X
NC5017805363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO137300003Medicare PIN