Provider Demographics
NPI:1891442372
Name:DEMETRIOU, BRANDI (CRNA)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:DEMETRIOU
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 S ALLEN AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-5301
Mailing Address - Country:US
Mailing Address - Phone:757-403-5433
Mailing Address - Fax:
Practice Address - Street 1:13 S ALLEN AVE UNIT B
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-5301
Practice Address - Country:US
Practice Address - Phone:757-403-5433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-04
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY855354367500000X
VA0001283967163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered