MEDICARE: MRS. SIMONE BRUMFIELD RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	277349	OH

General Provider Information

NPI Number	:	1316082977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SIMONE BRUMFIELD RN

Provider Business Mailing Address
First Line	:	1159 ERIEVIEW RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-2423
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1159 ERIEVIEW RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-2423
Country	:	US
Telephone Number	:	216-269-7590
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	01/24/2017

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