Provider Demographics
NPI:1477029395
Name:BROWN, MAGGIE ASHTON
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:ASHTON
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 1:600 HIGHWAY 425 N STE B
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:AR
Mailing Address - Zip Code:71655-4020
Mailing Address - Country:US
Mailing Address - Phone:870-224-7100
Mailing Address - Fax:870-224-0373
Practice Address - Street 1:600 HIGHWAY 425 N STE B
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:AR
Practice Address - Zip Code:71655-4020
Practice Address - Country:US
Practice Address - Phone:870-224-7100
Practice Address - Fax:870-224-0373
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator