Provider Demographics
NPI:1972248466
Name:GOINS, BRENDA R
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:R
Last Name:GOINS
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 1:19014 CHICKASAW AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44119-2730
Mailing Address - Country:US
Mailing Address - Phone:216-406-1803
Mailing Address - Fax:
Practice Address - Street 1:328 HALLE DR
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-1024
Practice Address - Country:US
Practice Address - Phone:216-406-1803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty