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General NPI Number Information
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NPI Number | 1538526660
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Entity Type | Individual
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Provider Name | ROBERT BRILEY
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Gender | Male
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Dates
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Enumeration Date | 01/20/2016
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 1266 GA-515
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City | JASPER
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State | GA
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Zip | 30143
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Country | US
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Telephone | 706-692-2441
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Fax |
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Provider Business Mailing Address
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Address Line | 101 EDGEWATER TRL
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City | CANTON
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State | GA
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Zip | 30115-1812
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Country | US
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Telephone | 912-536-0664
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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 | RN201526
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License Number State | GA
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