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NPI Code Detail

MEDICARE: BRANDY P. ELVINGTON CRNA

MEDICARE: BRANDY P. ELVINGTON 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
1367500000XCertified Registered Nurse AnesthetistRN168816GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508852229
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDY P. ELVINGTON CRNA
Provider Business Mailing Address
First Line : 1151 CLIFF DAWSON RD
Second Line :
City : WATKINSVILLE
State : GA
Zip : 30677-1978
Country : US
Telephone Number : 678-371-1775
Fax Number :
Provider Business Practice Location Address
First Line : 2151 W SPRING ST
Second Line :
City : MONROE
State : GA
Zip : 30655-3202
Country : US
Telephone Number : 678-371-1775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2005
Last Update Date : 10/09/2025

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