Provider Demographics
NPI:1629254677
Name:BROWN, MELODI ANNE (RN)
Entity Type:Individual
Prefix:MS
First Name:MELODI
Middle Name:ANNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1887 SHUMWAY AVE
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-5009
Mailing Address - Country:US
Mailing Address - Phone:307-277-3481
Mailing Address - Fax:
Practice Address - Street 1:1887 SHUMWAY AVE
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-5009
Practice Address - Country:US
Practice Address - Phone:307-277-3481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-20
Last Update Date:2008-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY23756163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse