Provider Demographics
NPI:1700260569
Name:HORN, BRYANNE (CRNA)
Entity Type:Individual
Prefix:
First Name:BRYANNE
Middle Name:
Last Name:HORN
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Gender:F
Credentials:CRNA
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Mailing Address - Street 1:PO BOX 1309
Mailing Address - Street 2:8170 33RD AVE S MAIL STOP 21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:651-254-6512
Mailing Address - Fax:651-254-3048
Practice Address - Street 1:640 JACKSON ST
Practice Address - Street 2:MAIL STOP 11503P
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2502
Practice Address - Country:US
Practice Address - Phone:651-254-6512
Practice Address - Fax:651-254-3048
Is Sole Proprietor?:No
Enumeration Date:2015-07-11
Last Update Date:2015-10-07
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Provider Licenses
StateLicense IDTaxonomies
MNR201347-7367500000X
MN1799367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered