Donna J Brenenstall, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209001128 Issued in IL

Practice address

5401 N Knoxville Ave Ste 114
Peoria, IL 61614-5091

Phone

(309) 689-8477

Fax

(309) 683-0201

NPI assigned

Mar 29, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1407817422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 N KNOXVILLE AVE STE 114",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145091",
            "telephone_number": "309-689-8477",
            "fax_number": "309-683-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 N KNOXVILLE AVE STE 114",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145091",
            "telephone_number": "309-689-8477",
            "fax_number": "309-683-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENENSTALL",
        "first_name": "DONNA",
        "middle_name": "J",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209001128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONT SUBS",
            "identifier": "309001107",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN",
            "identifier": "209001128",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "041149492",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melinda Breede, MA, NCC, LCPC
• Amanda Breeden, LCPC
• Grace Breitbach
• Rudolf G Breitmeyer, PHD
• Lorena Brejc, LCSW
• Mary L Brennan, NP
• Calee Michelle Bresnahan, MD
• Lisa G Bresnahan, LCSW
• Owen Brewer, MD
• Taylor Brewer

• Nurse Practitioner in Peoria, IL
• Providers in Peoria, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.