1598733024 NPI number — NANCY M BRENTON M.D.

Table of content: NANCY M BRENTON M.D. (NPI 1598733024)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598733024 NPI number — NANCY M BRENTON M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRENTON
Provider First Name:
NANCY
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598733024
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/04/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
505 HISTORIC DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STRASBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17579-1479
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-687-0313
Provider Business Mailing Address Fax Number:
717-687-3604

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
505 HISTORIC DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STRASBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17579-1479
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-687-0313
Provider Business Practice Location Address Fax Number:
717-687-3604
Provider Enumeration Date:
03/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  MD071232L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7734681 . This is a "AETNA NON-HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 875625 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 01348202 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 080158968 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 77533 S1QJ . This is a "GEISINGER HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0018093900001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1086301 . This is a "AETNA HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P002750 . This is a "GATEWAY HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: H18326 . This is a "HEALTH ASSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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