Individual
PETER GILBERT BRAINARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
77 W FOREST AVE STE 207, FLAGSTAFF, AZ 86001-1483
(928) 773-2505
(928) 773-2504
Mailing address
PO BOX 27568, SALT LAKE CITY, UT 84127-0568
(928) 773-2505
(928) 773-2504
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
TCRNA0880
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
746503
—
AZ
Enumeration date
06/17/2012
Last updated
06/16/2017
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