Provider Demographics
NPI:1700489234
Name:BROWNFIELD, COREY JON I
Entity Type:Individual
Prefix:MR
First Name:COREY
Middle Name:JON
Last Name:BROWNFIELD
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 HIDDEN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:OH
Mailing Address - Zip Code:43515-9111
Mailing Address - Country:US
Mailing Address - Phone:567-454-1028
Mailing Address - Fax:
Practice Address - Street 1:310 HIDDEN RIDGE DR
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:OH
Practice Address - Zip Code:43515-9111
Practice Address - Country:US
Practice Address - Phone:567-454-1028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No376J00000XNursing Service Related ProvidersHomemaker