Provider Demographics
NPI:1114626140
Name:BROWN, SARAH ROSE (RN)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ROSE
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:ROSE
Other - Last Name:PANICI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1301 COLLINS LN
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959-1478
Mailing Address - Country:US
Mailing Address - Phone:618-697-5342
Mailing Address - Fax:
Practice Address - Street 1:2401 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-1188
Practice Address - Country:US
Practice Address - Phone:618-997-5311
Practice Address - Fax:618-998-5664
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041445204163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse