Provider Demographics
NPI:1841557634
Name:BROWN, KIERA JANE (LPN)
Entity Type:Individual
Prefix:MS
First Name:KIERA
Middle Name:JANE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HANOVER PL
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11763-4039
Mailing Address - Country:US
Mailing Address - Phone:516-444-1094
Mailing Address - Fax:
Practice Address - Street 1:5 HANOVER PL
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763-4039
Practice Address - Country:US
Practice Address - Phone:516-444-1094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308878164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse