Provider Demographics
NPI:1023561578
Name:BROWN, ANGELLA D (RN)
Entity Type:Individual
Prefix:MS
First Name:ANGELLA
Middle Name:D
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 PEARSOLE DRIVE
Mailing Address - Street 2:#D 1E
Mailing Address - City:MT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-3945
Mailing Address - Country:US
Mailing Address - Phone:347-275-0265
Mailing Address - Fax:
Practice Address - Street 1:180 PEARSOLE DRIVE
Practice Address - Street 2:APT D1E
Practice Address - City:MT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552
Practice Address - Country:US
Practice Address - Phone:347-275-0265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY543071163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult