Provider Demographics
NPI:1114169935
Name:BROWN, JUDITH C (LPN)
Entity Type:Individual
Prefix:MISS
First Name:JUDITH
Middle Name:C
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 1:3959 DICKSON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-1305
Mailing Address - Country:US
Mailing Address - Phone:513-255-5401
Mailing Address - Fax:513-834-5519
Practice Address - Street 1:3959 DICKSON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-1305
Practice Address - Country:US
Practice Address - Phone:513-255-5401
Practice Address - Fax:513-834-5519
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-25
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN104625164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse