Provider Demographics
NPI:1063810406
Name:KRAWCZYK, BRANDON (CRNA DNP)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:KRAWCZYK
Suffix:
Gender:
Credentials:CRNA DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 COHANSEY ST
Mailing Address - Street 2:104
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-3598
Mailing Address - Country:US
Mailing Address - Phone:262-844-5581
Mailing Address - Fax:
Practice Address - Street 1:707 N FOREST AVE
Practice Address - Street 2:
Practice Address - City:WEBSTER GROVES
Practice Address - State:MO
Practice Address - Zip Code:63119-1927
Practice Address - Country:US
Practice Address - Phone:262-844-5581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-17
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021022479367500000X
MO2024033495163W00000X
MNR 233672-0163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered