Provider Demographics
NPI:1376707091
Name:BROWN, RITA MARIE (MLPN)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MLPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NORTHEAST HEALTH CENTER 5400 EAST 7 MILE ROAD
Mailing Address - Street 2:ROOM 35
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234
Mailing Address - Country:US
Mailing Address - Phone:313-870-3048
Mailing Address - Fax:313-368-4694
Practice Address - Street 1:NORTHEAST HEALTH CENTER 5400 EAST 7 MILE ROAD
Practice Address - Street 2:ROOM 35
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234
Practice Address - Country:US
Practice Address - Phone:313-870-3048
Practice Address - Fax:313-368-4694
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703065102164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse