Provider Demographics
NPI:1538636741
Name:BROWN, EMY KRISTINE
Entity Type:Individual
Prefix:MRS
First Name:EMY
Middle Name:KRISTINE
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 1:4111 S SEMORAN BLVD APT 15
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-2416
Mailing Address - Country:US
Mailing Address - Phone:321-274-6734
Mailing Address - Fax:
Practice Address - Street 1:4111 S SEMORAN BLVD APT 15
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-2416
Practice Address - Country:US
Practice Address - Phone:321-274-6734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator