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General NPI Number Information
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NPI Number | 1033445622
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Entity Type | Individual
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Provider Name | BRIAN THOMAS BRISTER CRNA
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Gender | Male
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Dates
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Enumeration Date | 11/02/2009
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 101 SIVLEY RD SW
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City | HUNTSVILLE
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State | AL
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Zip | 35801-4470
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Country | US
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Telephone | 256-265-8120
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Fax | 245-265-2186
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Provider Business Mailing Address
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Address Line | 101 SIVLEY RD SW
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City | HUNTSVILLE
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State | AL
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Zip | 35801-4470
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Country | US
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Telephone | 256-265-8120
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Fax | 245-265-2186
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 1-095759
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License Number State | AL
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