Individual
TRAVIS SCOTT BRUBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 GENESYS PKWY, GRAND BLANC, MI 48439-8065
(810) 606-5000
Mailing address
408 KINGSLEY ST, PHILADELPHIA, PA 19128-3602
(989) 859-4887
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704306255
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2022
Last updated
05/16/2022
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