Healthcare Provider Details

I. General information

NPI: 1811374259
Provider Name (Legal Business Name): YACINE BRUMANT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2015
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6984 RASPBERRY RDG
LIBERTY TWP OH
45011-9130
US

IV. Provider business mailing address

6984 RASPBERRY RDG
LIBERTY TWP OH
45011-9130
US

V. Phone/Fax

Practice location:
  • Phone: 973-280-1341
  • Fax:
Mailing address:
  • Phone: 973-280-1341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0042446
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: