Provider Demographics
NPI:1174526842
Name:NEUMANN, BRENNA JEAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRENNA
Middle Name:JEAN
Last Name:NEUMANN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:BRENNA
Other - Middle Name:JEAN
Other - Last Name:BUTTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:905 SW ELM TREE RD
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3537
Mailing Address - Country:US
Mailing Address - Phone:479-644-0910
Mailing Address - Fax:
Practice Address - Street 1:100 W DICKSON ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-5219
Practice Address - Country:US
Practice Address - Phone:479-442-6262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR10052183500000X
MO2002027543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO356006411Medicaid