Brenham, Careyana M

Brenham, Careyana M is an individual health care provider with primary practice located at 520 N 4Th St , Springfield IL 62702-5238. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Brenham, Careyana M can be contacted via phone (217) 757-8100.

Contact Information

Primary practice address
520 N 4Th St Springfield IL 62702-5238
Fax: (217) 757-8161
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036108158 Illinois

Profile Details

NPI number 1568451946
LBN Legal business name Brenham, Careyana M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2005
Last updated Oct 20th, 2020 - about 4 years ago

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 1568451946 NPPES
Illinois MEDICAID 036108158

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