Healthcare Provider Details

I. General information

NPI: 1063341063
Provider Name (Legal Business Name): BRYAN COLEMAN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3390 N CAMPBELL AVE STE 110
TUCSON AZ
85719-2380
US

IV. Provider business mailing address

3390 N CAMPBELL AVE STE 110
TUCSON AZ
85719-2380
US

V. Phone/Fax

Practice location:
  • Phone: 520-795-7650
  • Fax: 520-325-1622
Mailing address:
  • Phone: 520-795-7650
  • Fax: 520-325-1622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: