Provider Demographics
NPI:1578282588
Name:BROWN, ROBERT EMANUEL
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:EMANUEL
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 JANET DR
Mailing Address - Street 2:
Mailing Address - City:SAINT ROSE
Mailing Address - State:LA
Mailing Address - Zip Code:70087-3745
Mailing Address - Country:US
Mailing Address - Phone:504-329-5588
Mailing Address - Fax:
Practice Address - Street 1:172 JANET DR
Practice Address - Street 2:
Practice Address - City:SAINT ROSE
Practice Address - State:LA
Practice Address - Zip Code:70087-3745
Practice Address - Country:US
Practice Address - Phone:504-329-5588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program