MEDICARE: BRANDON FLETCHER CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	0001230828	VA
2	367500000X	Certified Registered Nurse Anesthetist	GAA-CRNA001465	GA

General Provider Information

NPI Number	:	1073069738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON FLETCHER CRNA

Provider Business Mailing Address
First Line	:	6600 VAN AALST BLVD
Second Line	:	MARTIN ARMY COMMUNITY HOSPITAL
City	:	COLUMBUS
State	:	GA
Zip	:	31905-5637
Country	:	US
Telephone Number	:	706-544-2563
Fax Number	:

Provider Business Practice Location Address
First Line	:	6600 VAN AALST BLVD
Second Line	:	MARTIN ARMY COMMUNITY HOSPITAL
City	:	COLUMBUS
State	:	GA
Zip	:	31905-5637
Country	:	US
Telephone Number	:	706-544-2563
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2016
Last Update Date	:	03/05/2026

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