Provider Demographics
NPI:1043442262
Name:BROWN, DEBORAH ANN (LPN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
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 1:144 S 2ND AVE APT 2E
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-3524
Mailing Address - Country:US
Mailing Address - Phone:914-664-2288
Mailing Address - Fax:914-664-2288
Practice Address - Street 1:144 S 2ND AVE APT 2E
Practice Address - Street 2:2E
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-3524
Practice Address - Country:US
Practice Address - Phone:914-664-2288
Practice Address - Fax:914-664-2288
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY164412-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse