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General NPI Number Information
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NPI Number | 1851102149
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Entity Type | Individual
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Provider Name | BRANDON JAMES WEST CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 300 S BRUCE ST
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City | MARSHALL
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State | MN
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Zip | 56258-1934
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Country | US
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Telephone | 507-532-9661
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Fax |
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Provider Business Mailing Address
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Address Line | 809 VIKING DR
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City | MARSHALL
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State | MN
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Zip | 56258-3400
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Country | US
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Telephone | 605-951-7297
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2532696
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R052130
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License Number State | SD
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 3159
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License Number State | MN
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