Provider Demographics
NPI:1588013791
Name:BROWN, LADEANA (BS EDUCATION)
Entity Type:Individual
Prefix:MS
First Name:LADEANA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:BS EDUCATION
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 7220
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82717-7220
Mailing Address - Country:US
Mailing Address - Phone:307-680-6803
Mailing Address - Fax:
Practice Address - Street 1:69 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-0000
Practice Address - Country:US
Practice Address - Phone:307-680-6803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management