Provider Demographics
NPI:1225385941
Name:BROWN, TAMARA ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 W 3RD AVE
Mailing Address - Street 2:P.O. BOX 326
Mailing Address - City:MORRICE
Mailing Address - State:MI
Mailing Address - Zip Code:48857-2546
Mailing Address - Country:US
Mailing Address - Phone:517-625-5199
Mailing Address - Fax:
Practice Address - Street 1:2775 E LANSING DR
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-7755
Practice Address - Country:US
Practice Address - Phone:517-332-1616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704259111163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse