Provider Demographics
NPI:1477766285
Name:AUGSBACH, BRENDA IRENE (MSN, RNC, CRRN)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:IRENE
Last Name:AUGSBACH
Suffix:
Gender:F
Credentials:MSN, RNC, CRRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WYOMING ST
Mailing Address - Street 2:ELDERCARE
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2722
Mailing Address - Country:US
Mailing Address - Phone:937-208-3772
Mailing Address - Fax:937-208-5154
Practice Address - Street 1:1 WYOMING ST
Practice Address - Street 2:ELDERCARE
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2722
Practice Address - Country:US
Practice Address - Phone:937-208-3772
Practice Address - Fax:937-208-5154
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-212646163WG0600X
OHRN 212646163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1477766285Medicaid