Provider Demographics
NPI:1467224766
Name:BROWN, ROBBIE A
Entity Type:Individual
Prefix:
First Name:ROBBIE
Middle Name:A
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 N MCQUEEN RD APT 2038
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-1317
Mailing Address - Country:US
Mailing Address - Phone:480-790-2754
Mailing Address - Fax:
Practice Address - Street 1:2222 N MCQUEEN RD APT 2038
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-1317
Practice Address - Country:US
Practice Address - Phone:480-790-2754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No171W00000XOther Service ProvidersContractor
No372500000XNursing Service Related ProvidersChore Provider