Healthcare Provider Details

I. General information

NPI: 1174305296
Provider Name (Legal Business Name): GAEDA BRINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 10/16/2023
Certification Date: 10/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 DOVER AVE
AKRON OH
44320-2836
US

IV. Provider business mailing address

941 DOVER AVE
AKRON OH
44320-2836
US

V. Phone/Fax

Practice location:
  • Phone: 330-391-6847
  • Fax:
Mailing address:
  • Phone: 330-391-6847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: