Provider Demographics
NPI:1083469530
Name:BRICE, BREASIA MONICA
Entity Type:Individual
Prefix:
First Name:BREASIA
Middle Name:MONICA
Last Name:BRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14134
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45250-0134
Mailing Address - Country:US
Mailing Address - Phone:513-418-1825
Mailing Address - Fax:
Practice Address - Street 1:1310 SYCAMORE ST APT 111
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-0013
Practice Address - Country:US
Practice Address - Phone:513-418-1825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide