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General NPI Number Information
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NPI Number | 1770530511
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Entity Type | Individual
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Provider Name | BRIAN CALLAHAN CRNA
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Gender | Male
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 02/19/2009
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Provider Practice Location Address
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Address Line | 800 E 21ST ST
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City | SIOUX FALLS
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State | SD
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Zip | 57105-1016
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Country | US
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Telephone | 605-322-6400
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Fax | 605-322-6499
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Provider Business Mailing Address
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Address Line | 800 E 21ST ST PO BOX 5045
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City | SIOUX FALLS
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State | SD
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Zip | 57105-1016
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Country | US
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Telephone | 605-322-2754
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Fax | 605-322-2727
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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 | R1561137
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License Number State | MN
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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 | SD-CRNA CR000688
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License Number State | SD
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