Provider Demographics
NPI:1376217455
Name:BROWN, DORINDA LORENE
Entity Type:Individual
Prefix:MRS
First Name:DORINDA
Middle Name:LORENE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:DORINDA
Other - Middle Name:LORENE
Other - Last Name:RIDDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1300 N 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-9584
Mailing Address - Country:US
Mailing Address - Phone:970-347-2120
Mailing Address - Fax:
Practice Address - Street 1:1260 H ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-9115
Practice Address - Country:US
Practice Address - Phone:970-313-1091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator