Brogan, Jennine C

Brogan, Jennine C is an sole proprietor health care provider with primary practice located at 1190 Westwood Dr , Hamilton MT 59840-2343. 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. Brogan, Jennine C can be contacted via phone (406) 375-4714.

Contact Information

Primary practice address
1190 Westwood Dr Hamilton MT 59840-2343
Phone: (406) 375-4714
Fax: (406) 375-4709
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 70515 Montana

Profile Details

NPI number 1063532653
LBN Legal business name Brogan, Jennine C
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 29th, 2007
Last updated May 12th, 2021 - about 3 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 1063532653 NPPES
California Other 495954 LICENSE NUMBER
California MEDICAID 1063532653 LICENSE NUMBER
California MEDICAID GR0079700 LICENSE NUMBER
California MEDICAID 1063532653 LICENSE NUMBER
California Other ZZZ13858Z LICENSE NUMBER

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