Individual
CODY BRANDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2005 MORELAND BLVD, CHAMPAIGN, IL 61822-1426
(812) 907-0183
Mailing address
2005 MORELAND BLVD, CHAMPAIGN, IL 61822-1426
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28252655A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
28252655A
IN
Other
Enumeration date
04/19/2025
Last updated
05/29/2025
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