Provider Demographics
NPI:1073930913
Name:BROWN, JAMESE (CNA I, MED TECH,)
Entity Type:Individual
Prefix:
First Name:JAMESE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:CNA I, MED TECH,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-4111
Mailing Address - Country:US
Mailing Address - Phone:919-349-9054
Mailing Address - Fax:
Practice Address - Street 1:1301 VALLEY RD
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-4111
Practice Address - Country:US
Practice Address - Phone:919-349-9054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-27
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X, 372600000X
NC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372600000XNursing Service Related ProvidersAdult Companion