Provider Demographics
NPI:1053151324
Name:WEINBRENNER, BRETT AUSTIN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:AUSTIN
Last Name:WEINBRENNER
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:PRATT
Mailing Address - State:KS
Mailing Address - Zip Code:67124-3125
Mailing Address - Country:US
Mailing Address - Phone:620-672-7415
Mailing Address - Fax:
Practice Address - Street 1:420 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:PRATT
Practice Address - State:KS
Practice Address - Zip Code:67124-3125
Practice Address - Country:US
Practice Address - Phone:620-672-7415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-25
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSTMP-162413363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health