Provider Demographics
NPI:1760442537
Name:BREHM, DOUGLAS J (ARNP)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:J
Last Name:BREHM
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SW FRAZIER CIR
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-2800
Mailing Address - Country:US
Mailing Address - Phone:785-232-2044
Mailing Address - Fax:785-322-5567
Practice Address - Street 1:200 SW FRAZIER CIR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606
Practice Address - Country:US
Practice Address - Phone:785-232-2044
Practice Address - Fax:785-232-2044
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS74541363LA2200X
KS45763363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSQ59768Medicare UPIN