Individual provider · Type 1 NPI
Laura Lynn Brennecke, CRNP
Pediatric Nurse Practitioner · Philadelphia, PA
NPI number
1174995310
Active
Practice location
3401 Civic Center Blvd
Philadelphia, PA 19104-4399
Mailing address
409 Second Ave, Suite 303
Collegeville, PA 19426-3625
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | SP015549 (PA) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1174995310
Laura Lynn Brennecke, CRNP's National Provider Identifier is 1174995310, issued on Oct 27, 2015. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Philadelphia, PA. The record was last updated on Nov 14, 2019.