Provider Demographics
NPI:1447362850
Name:BRENNAN, JULIE B (CNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:B
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 E WESTERN RESERVE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44514-3359
Mailing Address - Country:US
Mailing Address - Phone:330-953-3414
Mailing Address - Fax:330-926-5855
Practice Address - Street 1:822 E WESTERN RESERVE RD STE 1
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44514-3359
Practice Address - Country:US
Practice Address - Phone:330-953-3414
Practice Address - Fax:330-926-5855
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-01411363LX0001X
OHAPRN.CNP.01411363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0121952Medicaid
OHPO7690Medicare UPIN