Provider Demographics
NPI:1093088478
Name:MCKNIGHT, BRANDON H (CRNA)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:H
Last Name:MCKNIGHT
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:140 GRANDVIEW AVE STE 103
Mailing Address - Street 2:WATERBURY ANESTHESIOLOGY ASSOCIATES, INC.
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-2518
Mailing Address - Country:US
Mailing Address - Phone:203-757-7000
Mailing Address - Fax:
Practice Address - Street 1:140 GRANDVIEW AVE STE 103
Practice Address - Street 2:WATERBURY ANESTHESIOLOGY ASSOCIATES, INC.
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2518
Practice Address - Country:US
Practice Address - Phone:203-757-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004942367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered