Individual
BRANDON MADSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1224 8TH ST, RUPERT, ID 83350-1599
(208) 436-0481
(208) 436-6038
Mailing address
1224 8TH ST, RUPERT, ID 83350-1599
(208) 436-0481
(208) 436-6038
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
6382424-3102
UT
367500000X
Certified Registered Nurse Anesthetist
47281
WY
367500000X
Certified Registered Nurse Anesthetist
Primary
79700
ID
Other
Enumeration date
12/02/2020
Last updated
06/05/2025
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