Provider Demographics
NPI:1528568185
Name:BROWN, TANISHEA LASHAY (LVN)
Entity Type:Individual
Prefix:
First Name:TANISHEA
Middle Name:LASHAY
Last Name:BROWN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4319 WALDEN TERRACE LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-4413
Mailing Address - Country:US
Mailing Address - Phone:314-600-8112
Mailing Address - Fax:
Practice Address - Street 1:14950 HEATHROW FOREST PKWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77032-3847
Practice Address - Country:US
Practice Address - Phone:281-921-2301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX304258164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse