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General NPI Number Information
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NPI Number | 1841832987
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Entity Type | Individual
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Provider Name | MARISSA RAE BRAR MSN, APRN, CNP
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Gender | Female
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Dates
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Enumeration Date | 10/10/2019
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Last Update Date | 09/24/2021
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE # G60
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-316-7370
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Fax |
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Provider Business Mailing Address
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Address Line | 280 BUCKINGHAM DR
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City | AURORA
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State | OH
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Zip | 44202-6748
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Country | US
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Telephone | 216-385-8011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.420376
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.024324
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN.CNP.024324
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License Number State | OH
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