Individual
BRANDON BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8028 RIDGE RD, SARALAND, AL 36571-8947
(251) 423-0304
Mailing address
8028 RIDGE RD, SARALAND, AL 36571-8947
(251) 423-0304
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-168843
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/15/2021
Last updated
06/25/2024
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