Individual
BREANN MARIE KUTZER MCMANUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
500 N NAPPANEE ST, SUITE 11-B, ELKHART, IN 46514-1503
(574) 522-9922
(574) 522-9926
Mailing address
500 N NAPPANEE ST, SUITE 11-B, ELKHART, IN 46514-1503
(574) 522-9922
(574) 522-9926
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28155028A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000569464
ANTHEM
IN
05
—
200922790
—
IN
Enumeration date
06/12/2008
Last updated
07/09/2021
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