Provider Demographics
NPI:1790595148
Name:BRENNA REICHMAN LLC
Entity type:Organization
Organization Name:BRENNA REICHMAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:BRENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:REICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN, AGNP-C
Authorized Official - Phone:510-599-3935
Mailing Address - Street 1:2735 SEQUOIA PKWY
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-2663
Mailing Address - Country:US
Mailing Address - Phone:510-599-3935
Mailing Address - Fax:
Practice Address - Street 1:2800 S STATE ST STE 215
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-7103
Practice Address - Country:US
Practice Address - Phone:734-547-3990
Practice Address - Fax:734-547-3980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty