Individual
KIMBERLY JO BRASSEUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PMHNP-BC
Contact information
Practice address
3099 SULLIVANT AVE STE H, COLUMBUS, OH 43204-1800
(614) 371-2303
Mailing address
4762 LEGARE LN, COLUMBUS, OH 43230-6388
(304) 593-0781
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN.471177
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.0028798
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0442071
—
OH
Enumeration date
05/08/2020
Last updated
05/04/2022
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