Healthcare Provider Details

I. General information

NPI: 1164835021
Provider Name (Legal Business Name): BRIANNA NACHE ASHFORD LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRIANNA NACHE ASHFORD LPN

II. Dates (important events)

Enumeration Date: 06/09/2014
Last Update Date: 11/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 E 154TH ST
CLEVELAND OH
44120-4914
US

IV. Provider business mailing address

5430 GRASMERE AVE
MAPLE HEIGHTS OH
44137-3564
US

V. Phone/Fax

Practice location:
  • Phone: 216-209-2922
  • Fax:
Mailing address:
  • Phone: 216-307-0680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number401162801110
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN.165610.MEDS-IV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: