Individual
BRIAN WAYNE CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
4035 SOUTHPOINT BLVD, JACKSONVILLE, FL 32216-0949
(904) 507-6077
Mailing address
6489 SHADEWATER DR, HILLIARD, OH 43026-6248
(614) 668-2771
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.320250-COA1
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11041227
FL
367500000X
Certified Registered Nurse Anesthetist
COA.13948-NA
OH
Other
Enumeration date
06/17/2012
Last updated
04/15/2026
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