Provider Demographics
NPI:1073819066
Name:BROWN, ANGELIA (CST)
Entity Type:Individual
Prefix:MS
First Name:ANGELIA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1214
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-1043
Mailing Address - Country:US
Mailing Address - Phone:678-677-7590
Mailing Address - Fax:
Practice Address - Street 1:848 BILTMORE CT
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-6747
Practice Address - Country:US
Practice Address - Phone:678-677-7590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist