Provider Demographics
NPI:1912678574
Name:BRENNA, HALEY CATHERINE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:CATHERINE
Last Name:BRENNA
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7610 GAULT ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1404
Mailing Address - Country:US
Mailing Address - Phone:512-848-1703
Mailing Address - Fax:
Practice Address - Street 1:7610 GAULT ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-1404
Practice Address - Country:US
Practice Address - Phone:512-848-1703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX972901163W00000X
TX1055495363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse