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NPI Code Detail

MEDICARE: CLINTON H. BRAKEBILL CRNA

MEDICARE:   CLINTON H. BRAKEBILL  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 AnesthetistRN181883TN
2367500000XCertified Registered Nurse AnesthetistGAA-CRNA000405GA

General Provider Information

NPI Number : 1992181382
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLINTON H. BRAKEBILL CRNA
Provider Business Mailing Address
First Line : PO BOX 204097
Second Line :
City : AUGUSTA
State : GA
Zip : 30917-4097
Country : US
Telephone Number : 706-466-4541
Fax Number : 706-650-1034
Provider Business Practice Location Address
First Line : 3651 WHEELER RD
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-6521
Country : US
Telephone Number : 706-651-3232
Fax Number : 706-650-1034
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2015
Last Update Date : 03/05/2026

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Directions to “ CLINTON H. BRAKEBILL CRNA” Practice Location

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