Provider Demographics
NPI:1215782248
Name:AUSTIN, BRANDI YVONNE-IRENE
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:YVONNE-IRENE
Last Name:AUSTIN
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 1:1459 S PLAINVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-2322
Mailing Address - Country:US
Mailing Address - Phone:330-696-7133
Mailing Address - Fax:
Practice Address - Street 1:1459 S PLAINVIEW DR
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-2322
Practice Address - Country:US
Practice Address - Phone:330-696-7133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker