Provider Demographics
NPI:1114509593
Name:BROWN, MIRIAM RUTH (DO)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:RUTH
Last Name:BROWN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1161 21ST AVENUE SOUTH MCN CC3322
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-2561
Mailing Address - Country:US
Mailing Address - Phone:615-343-4882
Mailing Address - Fax:615-343-7023
Practice Address - Street 1:1161 21ST AVENUE SOUTH
Practice Address - Street 2:MCN CC3322
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-2561
Practice Address - Country:US
Practice Address - Phone:615-343-4882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-25
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program