Individual
CODY BRAINARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 PEELER ST, KALAMAZOO, MI 49008-2300
(269) 345-8618
(269) 345-1508
Mailing address
PO BOX 5, BURNIPS, MI 49314-0005
(616) 335-1738
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704329204
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704329204
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704329204
MI LICENSE
MI
Enumeration date
07/30/2021
Last updated
08/29/2022
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