Provider Demographics
NPI:1083361836
Name:BROWN, JUSTINA (STNA,EKG,PHLEBOTOMY)
Entity Type:Individual
Prefix:
First Name:JUSTINA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:STNA,EKG,PHLEBOTOMY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1692 NORTHRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-2811
Mailing Address - Country:US
Mailing Address - Phone:740-870-7441
Mailing Address - Fax:
Practice Address - Street 1:1692 NORTHRIDGE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-2811
Practice Address - Country:US
Practice Address - Phone:740-870-7441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH40211261018376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide