Provider Demographics
NPI:1114529260
Name:BRAWN, MAUREEN ANNE
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ANNE
Last Name:BRAWN
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 1:10164 STATE ROUTE 303
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:OH
Mailing Address - Zip Code:44288-9719
Mailing Address - Country:US
Mailing Address - Phone:133-021-9099
Mailing Address - Fax:
Practice Address - Street 1:10164 STATE ROUTE 303
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:OH
Practice Address - Zip Code:44288-9719
Practice Address - Country:US
Practice Address - Phone:133-021-9099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker