Provider Demographics
NPI:1043029630
Name:YUST, BRENNEN
Entity type:Individual
Prefix:
First Name:BRENNEN
Middle Name:
Last Name:YUST
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14210 HIGHWAY 43
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:MO
Mailing Address - Zip Code:64865-8427
Mailing Address - Country:US
Mailing Address - Phone:417-316-3401
Mailing Address - Fax:
Practice Address - Street 1:14210 HIGHWAY 43
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:MO
Practice Address - Zip Code:64865-8427
Practice Address - Country:US
Practice Address - Phone:417-316-3401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program