Provider Demographics
NPI:1558939645
Name:BROWN, SHAUNTE R
Entity Type:Individual
Prefix:
First Name:SHAUNTE
Middle Name:R
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 1:5802 E ITHACA PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-1121
Mailing Address - Country:US
Mailing Address - Phone:720-338-9125
Mailing Address - Fax:
Practice Address - Street 1:4891 INDEPENDENCE ST STE 285
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6793
Practice Address - Country:US
Practice Address - Phone:303-252-4477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide