Provider Demographics
NPI:1346720489
Name:BROWN, DIONNA ACHELLE (CPRM)
Entity Type:Individual
Prefix:MRS
First Name:DIONNA
Middle Name:ACHELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:CPRM
Other - Prefix:
Other - First Name:DIONNA
Other - Middle Name:ACHELLE
Other - Last Name:BRACEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPRM
Mailing Address - Street 1:2201 S GETTY ST
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-1207
Mailing Address - Country:US
Mailing Address - Phone:231-739-9315
Mailing Address - Fax:
Practice Address - Street 1:2201 S GETTY ST
Practice Address - Street 2:
Practice Address - City:MUSKEGON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:49444-1207
Practice Address - Country:US
Practice Address - Phone:231-739-9315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist