Provider Demographics
NPI:1033422050
Name:BROWN, TAMARA KAY (LPN)
Entity Type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:KAY
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5245 FRANKLIN CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:OH
Mailing Address - Zip Code:44837-9658
Mailing Address - Country:US
Mailing Address - Phone:419-512-6685
Mailing Address - Fax:
Practice Address - Street 1:5245 FRANKLIN CHURCH RD
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:OH
Practice Address - Zip Code:44837-9658
Practice Address - Country:US
Practice Address - Phone:419-512-6685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN125872164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse