Individual provider · NPI-1

Tara Lynn Brenner

Registered Nurse, General Practice · Cincinnati, OH

NPI number1407519978
StatusActive
Last updated in NPPESOct 20, 2021

Details

NPI
1407519978
Entity type
Individual (NPI-1)
Name
Mrs. Tara Lynn Brenner
Sex
Female
Sole proprietor
No
Enumeration date
Oct 20, 2021
Certification date
Oct 19, 2021
Last updated
Oct 20, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WG0000X Registered Nurse, General Practice347357OHYes

Practice location

375 Dixmyth Ave
Cincinnati, OH 45220-2475

Phone 513-862-4567

Mailing address

6302 Casey Ct
Fairfield, OH 45014-3686

Phone 513-675-6678

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