Brennan, Mary Jo
Brennan, Mary Jo is an individual health care provider with primary practice located at 1021 Summit Ave , Oconomowoc WI 53066-4457. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Brennan, Mary Jo can be contacted via phone (262) 567-9173.Contact Information
Primary practice address
1021 Summit Ave
Oconomowoc WI 53066-4457
Phone: (262) 567-9173
Fax: (262) 567-3034
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 08261-040 | Wisconsin |
Profile Details
| NPI number | 1134406671 |
|---|---|
| LBN Legal business name | Brennan, Mary Jo |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 11th, 2011 |
| Last updated | Nov 11th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134406671 | NPPES |
| Wisconsin | Other | 08261-040 | LICENSE NUMBER |
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