Provider Demographics
NPI:1457818155
Name:BROWN-RAHMAN, ELLEN DENISE (RN)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:DENISE
Last Name:BROWN-RAHMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 CASTLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-0169
Mailing Address - Country:US
Mailing Address - Phone:216-832-8790
Mailing Address - Fax:
Practice Address - Street 1:1504 CASTLE CREEK DR
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-0169
Practice Address - Country:US
Practice Address - Phone:216-832-8790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX877108163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse