Individual
BRENNAN VICTOR RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
300 NEW BERN AVE, RALEIGH, NC 27610-1111
(919) 350-8000
Mailing address
2430 EMERALD PL STE 201, GREENVILLE, NC 27834-5743
(252) 752-2140
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
265185
NC
367500000X
Certified Registered Nurse Anesthetist
111111111
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
322
NC
Other
Enumeration date
05/15/2013
Last updated
01/02/2024
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