Individual
BRIAN DOUGLAS DEATLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3333 BURNET AVE, CINCINNATI, OH 45229-3026
(513) 636-4200
Mailing address
3333 BURNET AVE, CINCINNATI, OH 45229-3026
(513) 636-4225
(513) 636-2511
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.019861
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN-362591
OHIO BOARD OF NURSING
OH
Enumeration date
10/24/2018
Last updated
02/22/2019
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