Healthcare Provider Details

I. General information

NPI: 1215219738
Provider Name (Legal Business Name): DIANA G BROWN-BRUMFIELD APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2011
Last Update Date: 09/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

672 QUILLIAMS RD
CLEVELAND HEIGHTS OH
44121-1954
US

IV. Provider business mailing address

672 QUILLIAMS RD
CLEVELAND HEIGHTS OH
44121-1954
US

V. Phone/Fax

Practice location:
  • Phone: 216-381-8510
  • Fax:
Mailing address:
  • Phone: 216-381-8510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number184859
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: