Provider Demographics
NPI:1376752527
Name:BRAZELL, DE'ONNA SHARICE (LPN)
Entity type:Individual
Prefix:MISS
First Name:DE'ONNA
Middle Name:SHARICE
Last Name:BRAZELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20979 ELLACOTT PKWY
Mailing Address - Street 2:APARTMENT #E-6
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-4475
Mailing Address - Country:US
Mailing Address - Phone:216-662-6599
Mailing Address - Fax:
Practice Address - Street 1:5882 KIMBERLY DR
Practice Address - Street 2:
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44146-3004
Practice Address - Country:US
Practice Address - Phone:440-439-9449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.118620.164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse