Provider Demographics
NPI:1023820552
Name:CAVANAUGH, BREANN ALLIE-MAKAY
Entity type:Individual
Prefix:MS
First Name:BREANN
Middle Name:ALLIE-MAKAY
Last Name:CAVANAUGH
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 1:2271 MANN RD
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:MI
Mailing Address - Zip Code:48659-9718
Mailing Address - Country:US
Mailing Address - Phone:424-844-5404
Mailing Address - Fax:
Practice Address - Street 1:1151 RINN ST
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509-2335
Practice Address - Country:US
Practice Address - Phone:810-494-1552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion