Provider Demographics
NPI:1407568983
Name:BROWN, MY'ZONIA
Entity Type:Individual
Prefix:
First Name:MY'ZONIA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12330 INLETRIDGE DR APT D
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-2047
Mailing Address - Country:US
Mailing Address - Phone:314-967-9915
Mailing Address - Fax:
Practice Address - Street 1:12330 INLETRIDGE DR APT D
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-2047
Practice Address - Country:US
Practice Address - Phone:314-967-9915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide