Provider Demographics
NPI:1831393370
Name:BRISSETT, PATRICIA A (CRNA)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:BRISSETT
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:A
Other - Last Name:GWAYI-CHORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-7687
Mailing Address - Fax:
Practice Address - Street 1:4940 EASTERN AVE # A5W-588
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2735
Practice Address - Country:US
Practice Address - Phone:410-550-0942
Practice Address - Fax:410-550-0443
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR143688367500000X
PARN561180367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA114075Medicare PIN