MRS. Brena Johnson Siddall, PA-C

NPI #1790978526 in Mc Rae, Georgia

Provider Information

NPI Number: 1790978526
Entity Type: Individual
Name: MRS. Brena Johnson Siddall, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Aug 24, 2007
Last Updated: Aug 20, 2015

Practice Location

Address: 280 E WILLOW CREEK LN
City: Mc Rae
State: Georgia
ZIP Code: 31055-5126
Phone: (478) 864-3448

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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