Provider Demographics
NPI:1902538036
Name:BRUSCIANELLI, MILDRED (CNM)
Entity Type:Individual
Prefix:
First Name:MILDRED
Middle Name:
Last Name:BRUSCIANELLI
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:MILDRED
Other - Middle Name:
Other - Last Name:SILVESTRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:9910 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-9787
Mailing Address - Country:US
Mailing Address - Phone:419-708-6794
Mailing Address - Fax:
Practice Address - Street 1:2150 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3834
Practice Address - Country:US
Practice Address - Phone:419-291-8539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife