NPI Code Detail JSON Logo

1689016636 NPI number — BRIAN K TANNER CRNA

NPI Number: 1689016636
Health Care Provider/Practitioner: BRIAN K TANNER CRNA

Information about “1689016636” NPI (BRIAN K TANNER CRNA) exists in 1689016636 in HTML format HTML  |  1689016636 in plain Text format TXT  |  1689016636 in PDF (Portable Document Format) PDF  |  1689016636 in an XML format XML  formats.

NPI Number : 1689016636 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1689016636",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TANNER",
    "FirstName": "BRIAN",
    "MiddleName": "K",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "CRNA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "690 CANTON ST STE 325",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WESTWOOD",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "02090-2324",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "781-407-7713",
    "MailingAddressFaxNumber": "781-407-0998",
    "FirstLinePracticeLocationAddress": "201 E SAMPLE RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DEERFIELD BEACH",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33064-3502",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "954-941-8300",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/18/2013",
    "LastUpdateDate": "10/08/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "367500000X",
          "TaxonomyName": "Certified Registered Nurse Anesthetist",
          "LicenseNumber": "1-115992",
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "367500000X",
          "TaxonomyName": "Certified Registered Nurse Anesthetist",
          "LicenseNumber": "APRN329135",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "367500000X",
          "TaxonomyName": "Certified Registered Nurse Anesthetist",
          "LicenseNumber": "APRN11041329",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "367500000X",
          "TaxonomyName": "Certified Registered Nurse Anesthetist",
          "LicenseNumber": "L6-OA10844",
          "LicenseNumberStateCode": "DE",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "367500000X",
          "TaxonomyName": "Certified Registered Nurse Anesthetist",
          "LicenseNumber": "791145",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "367500000X",
          "TaxonomyName": "Certified Registered Nurse Anesthetist",
          "LicenseNumber": "APRN10004453",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "367500000X",
          "TaxonomyName": "Certified Registered Nurse Anesthetist",
          "LicenseNumber": "C-APN.0104878-C-CRNA",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.