MR. ETHAN JOSEPH BRENNA (NPI# 1497269583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497269583 |
| Entity Type | Individual |
| Full Name | MR. ETHAN JOSEPH BRENNA |
| Credential | MSGC |
| Practice Address |
820 4th St N Fargo ND 58102-4539 |
| Practice Telephone | 7012342448 |
| Practice Fax Number | 7012347239 |
| Mailing Telephone | 7012342448 |
| Mailing Fax Number | 7012347239 |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2017-11-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 170300000X | Genetic Counselor, MS | Other Service Providers |
| Street Address |
820 4TH ST N |
| City | FARGO |
| State | ND |
| Zip Code | 58102-4539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922025907 | Anu G Gaba | Internal Medicine | 820 4th St N, Fargo, ND 58122-0001 | 2006-07-16 |
| 1023629631 | Pauline Aamodt | Genetic Counselor, MS | 820 4th St N, Fargo, ND 58102-4539 | 2020-08-17 |
| 1710507561 | Brittany Nicole Twiss | Dietitian, Registered | 820 4th St N, Fargo, ND 58102-4539 | 2020-04-22 |
| 1366092801 | Sanford Medical Center Fargo | Hospice Care, Community Based | 820 4th St N, Fargo, ND 58102-4539 | 2019-09-17 |
| 1154807741 | Morgan Rinke | Nurse Practitioner | 820 4th St N, Fargo, ND 58102-4539 | 2018-07-17 |
| 1265885867 | Carrie Pfaff | Nurse Practitioner | 820 4th St N, Fargo, ND 58102-4539 | 2016-07-19 |
| 1316315385 | Sharri M Lacher | Clinical Nurse Specialist | 820 4th St N, Fargo, ND 58102-4539 | 2015-09-09 |
| 1487022885 | John Roll | Clinical Nurse Specialist | 820 4th St N, Fargo, ND 58102-4539 | 2015-09-02 |
| 1699181495 | Kirk David Wyatt | Pediatrics | 820 4th St N, Fargo, ND 58102-4539 | 2014-07-01 |
| 1205247913 | Sommer Rae Wild Nurkic | Radiology | 820 4th St N, Fargo, ND 58102-4539 | 2014-05-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285924 | Shelley Dene Townsend-hansen | Dentist | 1017 Broadway N, Fargo, ND 58102 | 2020-11-04 |
| 1275190779 | Anthony Joseph Duncan | Student in an Organized Health Care Education/Training Program | 1919 Elm Streent North, Fargo, ND 58102 | 2019-05-21 |
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1124523576 | Christopher Peroutka | Specialist/Technologist | 1300 17th Ave N, Fargo, ND 58102 | 2018-03-28 |
| 1205331873 | Nathan Koens | Specialist/Technologist | 1300 17th Avenue North, Fargo, ND 58102 | 2018-03-27 |
| 1376063370 | Abby Nicole Fredrickson | Student in an Organized Health Care Education/Training Program | 1919 Elm Street North, Fargo, ND 58102 | 2017-06-21 |
| 1780118331 | Stephanie Melquist | Internal Medicine | Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 | 2017-04-19 |
| 1104215623 | Justin Lervik | Social Worker | 211 Elm St. N, 122, Fargo, ND 58102 | 2015-01-21 |
| 1770919441 | Courtney Ann Simanski | Speech-Language Pathologist | 415 4th St. N., Fargo, ND 58102 | 2013-09-25 |
| 1821431206 | Lanell Staroba | Pharmacist | 706 D 38th St, Fargo, ND 58102 | 2013-04-16 |
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| Taxonomy Code | 170300000X |
| Grouping | Other Service Providers |
| Classification | Genetic Counselor, MS |
| A masters trained health care provider who collects and interprets genetic family histories; assesses the risk of disease occurrence or recurrence; identifies interventions to manage or ameliorate disease risk; educates about inheritance, testing, management, prevention, ethical issues, resources, and research; and counsels to promote informed choices and adaptation. Certification was established in 1993 by the American Board of Genetic Counseling and prior to that by the American Board of Medical Genetics. Requirements for experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: National Society of Genetic Counselors [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023629631 | Pauline Aamodt | Genetic Counselor, MS | 820 4th St N, Fargo, ND 58102-4539 | 2020-08-17 |
| 1063022432 | Lindsey Schmidt | Genetic Counselor, MS | 801 Broadway N, Fargo, ND 58102-3641 | 2020-07-31 |
| 1194344036 | Sarah Rose Carpenter | Genetic Counselor, MS | 801 Broadway N, Fargo, ND 58102-3641 | 2020-04-10 |
| 1619457173 | Ellen Johnson | Genetic Counselor, MS | 1111 Harwood Dr S, Fargo, ND 58104-4603 | 2018-08-15 |
| 1215451331 | Gabriel Jack Kringlen | Genetic Counselor, MS | 801 Broadway N, Fargo, ND 58102-3641 | 2017-07-31 |
| 1518415124 | Meghann Reardon | Genetic Counselor, MS | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2016-09-13 |
| 1598147456 | Heidi Albers | Genetic Counselor, MS | 801 Broadway N, Fargo, ND 58102-3641 | 2015-06-26 |
| 1245612118 | Morgan Fisher | Genetic Counselor, MS | 801 Broadway N, Fargo, ND 58102-3641 | 2015-06-26 |
| 1174924815 | Lauryn Lapoint | Genetic Counselor, MS | 801 Broadway N, Rt 1220, Fargo, ND 58102-3641 | 2014-09-12 |
| 1659360162 | Cathleen Lee Mccann | Genetic Counselor, MS | 1702 University Dr S, Fargo, ND 58103 | 2005-10-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.