Provider Demographics
NPI:1548414394
Name:BROWN, JOSEPH SIDNEY (RN)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:SIDNEY
Last Name:BROWN
Suffix:
Gender:M
Credentials:RN
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 636
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32056-0636
Mailing Address - Country:US
Mailing Address - Phone:386-752-8620
Mailing Address - Fax:
Practice Address - Street 1:1404 SOUTH MARION AVENUE #201
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-0636
Practice Address - Country:US
Practice Address - Phone:386-752-8620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1942952163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse