Brenenstall, Donna J

Brenenstall, Donna J is an individual health care provider with primary practice located at 5401 N Knoxville Ave Ste 114 , Peoria IL 61614-5091. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Brenenstall, Donna J can be contacted via phone (309) 689-8477.

Contact Information

Primary practice address
5401 N Knoxville Ave Ste 114 Peoria IL 61614-5091
Phone: (309) 689-8477
Fax: (309) 683-0201
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209001128 Illinois

Profile Details

NPI number 1407817422
LBN Legal business name Brenenstall, Donna J
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2006
Last updated Mar 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407817422 NPPES
Other 309001107 CONT SUBS
Other 209001128 CONT SUBS
Other 041149492 CONT SUBS

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