Ethan Joseph Brenna, MSGC

Primary specialty

Genetic Counselor (M.S.)Taxonomy code 170300000X

Practice address

820 4TH St N
Fargo, ND 58102-4539

Phone

(701) 234-2448

Fax

(701) 234-7239

NPI assigned

Nov 28, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511827200000",
    "number": "1497269583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 4TH ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024539",
            "telephone_number": "701-234-2448",
            "fax_number": "701-234-7239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 4TH ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024539",
            "telephone_number": "701-234-2448",
            "fax_number": "701-234-7239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNA",
        "first_name": "ETHAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "MSGC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-28",
        "last_updated": "2017-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Genetic Counselor, MS",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie L Brekken, PA-C
• James Mikel Breland
• Krista Bremner, RN, BSN
• Lukas John Brendemuhl, PEER SUPPORT
• Mary Ellen Breneman-Turner, PT
• Stacey Jo Brenna
• Taryn Brenna, LAC
• Mark J Brenner
• Terri Brenner
• Brent L Holman DDS PC

• Genetic Counselor (M.S.) in Fargo, ND
• Providers in Fargo, ND by specialty
• Genetic Counselor (M.S.) in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; 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.