Provider Demographics
NPI:1518438498
Name:BROWN, JAVETTIA REBECCA
Entity Type:Individual
Prefix:
First Name:JAVETTIA
Middle Name:REBECCA
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 1:5718 ARTS ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-5314
Mailing Address - Country:US
Mailing Address - Phone:504-435-0015
Mailing Address - Fax:
Practice Address - Street 1:5718 ARTS ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-5314
Practice Address - Country:US
Practice Address - Phone:504-435-0015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
343900000X
LA092505266343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)