Provider Demographics
NPI:1629643556
Name:GLENN, BRIANNA CHELAYNE
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:CHELAYNE
Last Name:GLENN
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 1:8031 GREENWOOD VIEW DR APT 1210
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-5861
Mailing Address - Country:US
Mailing Address - Phone:216-849-2959
Mailing Address - Fax:
Practice Address - Street 1:8031 GREENWOOD VIEW DR APT 1210
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5861
Practice Address - Country:US
Practice Address - Phone:216-849-2959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide