Provider Demographics
NPI:1467914648
Name:BROWN, BETTY JEAN
Entity Type:Individual
Prefix:MISS
First Name:BETTY
Middle Name:JEAN
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:BETTY
Other - Middle Name:JEAN
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:510 JAMES ST APT A
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-5124
Mailing Address - Country:US
Mailing Address - Phone:315-880-2042
Mailing Address - Fax:
Practice Address - Street 1:510 JAMES ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-5124
Practice Address - Country:US
Practice Address - Phone:315-880-2042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty