Provider Demographics
NPI:1932716735
Name:FEHRMAN, BREANNE RAE
Entity Type:Individual
Prefix:
First Name:BREANNE
Middle Name:RAE
Last Name:FEHRMAN
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 1:1571 CARMEL DR
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-5566
Mailing Address - Country:US
Mailing Address - Phone:937-707-8575
Mailing Address - Fax:
Practice Address - Street 1:1571 CARMEL DR
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-5566
Practice Address - Country:US
Practice Address - Phone:937-707-8575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide