Provider Demographics
NPI:1447681739
Name:GOLDSMITH, BREANN D HILL (NP)
Entity type:Individual
Prefix:MRS
First Name:BREANN
Middle Name:D HILL
Last Name:GOLDSMITH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:BREANN
Other - Middle Name:D
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:7951 SHOAL CREEK BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-7582
Mailing Address - Country:US
Mailing Address - Phone:512-584-8404
Mailing Address - Fax:
Practice Address - Street 1:1509 STONECREEK DR S
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147
Practice Address - Country:US
Practice Address - Phone:740-653-2500
Practice Address - Fax:740-653-2552
Is Sole Proprietor?:No
Enumeration Date:2013-12-11
Last Update Date:2018-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.16778363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0150153Medicaid
OH0150153Medicaid