Basic Information
Provider Information
NPI: 1003000860
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRENNAN
FirstName: JANICE
MiddleName: M
NamePrefix: MRS.
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 MEDICAL CENTER DR
Address2: DHMC DEPARTMENT OF OCCUPATION MEDICINE
City: LEBANON
State: NH
PostalCode: 037561000
CountryCode: US
TelephoneNumber: 6035605000
FaxNumber: 6036500787
Practice Location
Address1: 1 MEDICAL CENTER DR
Address2: DHMC DEPARTMENT OF OCCUPATION MEDICINE
City: LEBANON
State: NH
PostalCode: 037561000
CountryCode: US
TelephoneNumber: 6035605000
FaxNumber: 6036500787
Other Information
ProviderEnumerationDate: 09/04/2007
LastUpdateDate: 07/24/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X012872-23-03NHY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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