Provider Demographics
NPI:1629650957
Name:FORD BROWN, QUOWANDA LA'KECIA (RN)
Entity Type:Individual
Prefix:
First Name:QUOWANDA
Middle Name:LA'KECIA
Last Name:FORD 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 1:723 NW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33311-9007
Mailing Address - Country:US
Mailing Address - Phone:954-809-4157
Mailing Address - Fax:
Practice Address - Street 1:723 NW 2ND ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-9007
Practice Address - Country:US
Practice Address - Phone:954-809-4157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9241527163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse