Provider Demographics
NPI:1558622761
Name:BROWN, DEBORAH TEMI
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:TEMI
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 60425
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20039-0425
Mailing Address - Country:US
Mailing Address - Phone:202-714-4140
Mailing Address - Fax:
Practice Address - Street 1:2907 NOVEMBER CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1354
Practice Address - Country:US
Practice Address - Phone:202-714-4140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC557316459172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker