Provider Demographics
NPI:1194252817
Name:BRINSER, JONATHAN (CRNA)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:BRINSER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 LEE KING RD
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:GA
Mailing Address - Zip Code:31029-6202
Mailing Address - Country:US
Mailing Address - Phone:478-397-6429
Mailing Address - Fax:
Practice Address - Street 1:40 LEE KING RD
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:GA
Practice Address - Zip Code:31029-6202
Practice Address - Country:US
Practice Address - Phone:478-397-6429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN205521367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered