Provider Demographics
NPI:1326589193
Name:BROWN, PATRICE (HHA)
Entity Type:Individual
Prefix:
First Name:PATRICE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:PAT
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HHA
Mailing Address - Street 1:PO BOX 202595
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-8126
Mailing Address - Country:US
Mailing Address - Phone:330-596-5134
Mailing Address - Fax:
Practice Address - Street 1:4183 E 143RD ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-1817
Practice Address - Country:US
Practice Address - Phone:330-596-5134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-13
Last Update Date:2017-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3654030374U00000X
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Yes374U00000XNursing Service Related ProvidersHome Health Aide