Individual
MR. TIMOTHY BRANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
615 W NURSERY ST, BUTLER, MO 64730-1840
(660) 200-7000
(660) 200-7015
Mailing address
615 W NURSERY ST, BUTLER, MO 64730-1840
(660) 200-7000
(660) 200-7015
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
148622
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
912724317
—
MO
05
—
919038307
—
MO
Enumeration date
05/18/2006
Last updated
06/03/2008
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