Provider Demographics
NPI:1144429994
Name:WOLFORD, BRENNA ELENA (CRNA)
Entity type:Individual
Prefix:MS
First Name:BRENNA
Middle Name:ELENA
Last Name:WOLFORD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MRS
Other - First Name:BRENNA
Other - Middle Name:ELENA
Other - Last Name:LOPEZ-OTERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:13400 E SHEA BLVD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-5499
Mailing Address - Country:US
Mailing Address - Phone:480-301-8000
Mailing Address - Fax:
Practice Address - Street 1:61069 SE ECHO LAKE CT.
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702
Practice Address - Country:US
Practice Address - Phone:541-490-3527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ39367500000X
CA2976367500000X
OR200560029CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered