Provider Demographics
NPI:1275800039
Name:BROWN, WHITTNEY JOVONE
Entity Type:Individual
Prefix:MRS
First Name:WHITTNEY
Middle Name:JOVONE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:WHITTNEY
Other - Middle Name:JOVONE
Other - Last Name:RICHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4285 N RANCHO DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-3446
Mailing Address - Country:US
Mailing Address - Phone:702-383-5331
Mailing Address - Fax:702-385-5678
Practice Address - Street 1:4285 N RANCHO DR STE 130
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3455
Practice Address - Country:US
Practice Address - Phone:702-383-5331
Practice Address - Fax:702-385-5678
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner