Provider Demographics
NPI:1235852872
Name:BROWN, KHADIJAH AFRICNNA
Entity Type:Individual
Prefix:
First Name:KHADIJAH
Middle Name:AFRICNNA
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5434 SANDS RD
Mailing Address - Street 2:
Mailing Address - City:LOTHIAN
Mailing Address - State:MD
Mailing Address - Zip Code:20711-9617
Mailing Address - Country:US
Mailing Address - Phone:443-876-9792
Mailing Address - Fax:
Practice Address - Street 1:2412 ELVANS RD SE APT 304
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-3582
Practice Address - Country:US
Practice Address - Phone:305-898-8090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant