Provider Demographics
NPI:1982760989
Name:BRENNAN, RACHEL CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:CHRISTINE
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4717 OAK RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-9742
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:202 CONWAY DR STE 200
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3153
Practice Address - Country:US
Practice Address - Phone:406-758-7490
Practice Address - Fax:406-758-7080
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN437512080P0207X
MTMED-PHYS-LIC-1127072080P0207X
MDP20019208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics