Healthcare Provider Details

I. General information

NPI: 1225844079
Provider Name (Legal Business Name): BRANDI PACE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2024
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3219 CLIFTON AVE STE 210
CINCINNATI OH
45220-3041
US

IV. Provider business mailing address

5092 JONATHAN WAY
INDEPENDENCE KY
41051-7305
US

V. Phone/Fax

Practice location:
  • Phone: 513-751-5900
  • Fax: 513-487-4590
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN.CNM.0019654
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: