Provider Demographics
NPI:1134418452
Name:REICHMAN, BRENNA (MSN, RN, AGNP-C)
Entity type:Individual
Prefix:MS
First Name:BRENNA
Middle Name:
Last Name:REICHMAN
Suffix:
Gender:F
Credentials:MSN, RN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 S STATE ST
Mailing Address - Street 2:STE 215
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-7103
Mailing Address - Country:US
Mailing Address - Phone:734-547-3990
Mailing Address - Fax:734-547-3980
Practice Address - Street 1:3201 BEMIS RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-9307
Practice Address - Country:US
Practice Address - Phone:734-434-2737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704307369363LA2200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse