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Individual

JEREMY HERBRANDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-6259
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-2119

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R28604
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
17847
ND
Enumeration date
01/23/2013
Last updated
03/27/2013
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