Provider Demographics
NPI:1710215306
Name:BROWN, SHAREN DOUGLAS (CRT, MSA)
Entity Type:Individual
Prefix:MRS
First Name:SHAREN
Middle Name:DOUGLAS
Last Name:BROWN
Suffix:
Gender:F
Credentials:CRT, MSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8320 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-6435
Mailing Address - Country:US
Mailing Address - Phone:317-529-6113
Mailing Address - Fax:
Practice Address - Street 1:8320 E 36TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-6435
Practice Address - Country:US
Practice Address - Phone:317-529-6113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula