Provider Demographics
NPI:1073348868
Name:BRENNER, LAUREN SYDNEY (PA-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:SYDNEY
Last Name:BRENNER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CENTURIAN DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2150
Mailing Address - Country:US
Mailing Address - Phone:302-366-8600
Mailing Address - Fax:
Practice Address - Street 1:1 CENTURIAN DR STE 200
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2150
Practice Address - Country:US
Practice Address - Phone:302-366-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant