Individual
MAX KYLE BRAINARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
425 PINE RIDGE BLVD STE 211, WAUSAU, WI 54401-4123
(715) 845-5505
Mailing address
1019 SAINT AUSTIN AVE, WAUSAU, WI 54403-6752
(608) 514-5261
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
139116
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
139116
WI
Other
Enumeration date
08/28/2018
Last updated
09/15/2020
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