Provider Demographics
NPI:1881981124
Name:MASH, BROOKE K (CNP)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:K
Last Name:MASH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 MEDINA RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2483
Mailing Address - Country:US
Mailing Address - Phone:330-665-8120
Mailing Address - Fax:330-665-8129
Practice Address - Street 1:4125 MEDINA RD
Practice Address - Street 2:SUITE 104
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-2483
Practice Address - Country:US
Practice Address - Phone:330-665-8120
Practice Address - Fax:330-665-8129
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.334093363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health