Provider Demographics
NPI:1477236024
Name:BROWN, YOLANDA SHARELL
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:SHARELL
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:PO BOX 96
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:OH
Mailing Address - Zip Code:45377-0096
Mailing Address - Country:US
Mailing Address - Phone:614-966-4919
Mailing Address - Fax:
Practice Address - Street 1:8475 GRACIES TRL
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-6166
Practice Address - Country:US
Practice Address - Phone:614-966-4919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant