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General NPI Number Information
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NPI Number | 1144008384
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Entity Type | Individual
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Provider Name | BRANDON JAY EDMONDSON DNAP, CRNA
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Gender | Male
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Dates
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Enumeration Date | 09/19/2023
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Last Update Date | 07/25/2026
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Provider Practice Location Address
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Address Line | 250 HOSPITAL PL
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City | SOLDOTNA
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State | AK
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Zip | 99669-7559
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Country | US
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Telephone | 907-714-4404
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Fax |
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Provider Business Mailing Address
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Address Line | 701 SOUTH ST STE 100
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-4452
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Country | US
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Telephone | 801-500-2475
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Fax |
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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 | 256117
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 233514
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License Number State | AR
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