Provider Demographics
NPI:1679457915
Name:BRUMFIELD, AUTUMN LYNE
Entity type:Individual
Prefix:MS
First Name:AUTUMN
Middle Name:LYNE
Last Name:BRUMFIELD
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 1:1398 E BETHEL CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-9602
Mailing Address - Country:US
Mailing Address - Phone:740-645-0523
Mailing Address - Fax:
Practice Address - Street 1:88 TOWNSHIP ROAD 1310
Practice Address - Street 2:
Practice Address - City:PROCTORVILLE
Practice Address - State:OH
Practice Address - Zip Code:45669-8834
Practice Address - Country:US
Practice Address - Phone:304-638-6154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health