Individual
BRIAN CLAY DENECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
801 E 6TH ST, SUITE 205, PANAMA CITY, FL 32401-3661
(850) 785-3185
(850) 785-6233
Mailing address
801 E 6TH ST, SUITE 205, PANAMA CITY, FL 32401-3661
(850) 785-3185
(850) 785-6233
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ANT3366552
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ANT3366552
LICENSE
FL
01
—
G4453
BCBS
FL
Enumeration date
02/05/2008
Last updated
04/18/2008
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