Provider Demographics
NPI:1033666573
Name:BRENNAN, COURTNEY (NP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 BROAD STREET SUITE 201 BUILDING B
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4368
Mailing Address - Country:US
Mailing Address - Phone:732-380-1212
Mailing Address - Fax:732-380-1372
Practice Address - Street 1:1131 BROAD STREET SUITE 201 BUILDING B
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4368
Practice Address - Country:US
Practice Address - Phone:732-380-1212
Practice Address - Fax:732-380-1372
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00662400363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner