Provider Demographics
NPI:1619542057
Name:BROWN, ANGEL TIERRA (HHA)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:TIERRA
Last Name:BROWN
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 SUNSET AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45205-1504
Mailing Address - Country:US
Mailing Address - Phone:513-344-0018
Mailing Address - Fax:
Practice Address - Street 1:1032 SUNSET AVE APT 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45205-1504
Practice Address - Country:US
Practice Address - Phone:513-344-0018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health