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Individual

BRYAN T KASEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
10031 N 26TH ST, PHOENIX, AZ 85028-4306
(602) 614-1696
Mailing address
10031 N 26TH ST, PHOENIX, AZ 85028-4306
(602) 614-1696

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA0183
AZ
367500000X
Certified Registered Nurse Anesthetist
RN101883
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
647133
AZ
01
P00150757
RAILROAD MEDICARE
AZ
Enumeration date
12/14/2005
Last updated
12/16/2014
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