Provider Demographics
NPI:1437244456
Name:BROWN, ANASTASIA G (RNFA)
Entity Type:Individual
Prefix:MRS
First Name:ANASTASIA
Middle Name:G
Last Name:BROWN
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:G
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RNFA
Mailing Address - Street 1:29 W 505 CERNY CIRCLE
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-2516
Mailing Address - Country:US
Mailing Address - Phone:630-393-3731
Mailing Address - Fax:630-393-3732
Practice Address - Street 1:2100 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-5487
Practice Address - Country:US
Practice Address - Phone:815-725-2121
Practice Address - Fax:815-741-6303
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041296478163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant