Provider Demographics
NPI:1124502885
Name:BRENN, KATRINA MARIE (RN)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:MARIE
Last Name:BRENN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:BLUE HILL
Mailing Address - State:NE
Mailing Address - Zip Code:68930-0284
Mailing Address - Country:US
Mailing Address - Phone:402-469-2297
Mailing Address - Fax:
Practice Address - Street 1:606 S SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:BLUE HILL
Practice Address - State:NE
Practice Address - Zip Code:68930-3535
Practice Address - Country:US
Practice Address - Phone:402-756-2085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE66927163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool