Provider Demographics
NPI:1841567328
Name:BROWN, DOROTHY LYDIA (CHP)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:LYDIA
Last Name:BROWN
Suffix:
Gender:F
Credentials:CHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1897 TUNDRA WAY
Mailing Address - Street 2:BOX 189
Mailing Address - City:NOORVIK
Mailing Address - State:AK
Mailing Address - Zip Code:99763-0189
Mailing Address - Country:US
Mailing Address - Phone:907-636-2103
Mailing Address - Fax:907-636-2195
Practice Address - Street 1:1897 TUNDRA WAY
Practice Address - Street 2:
Practice Address - City:NOORVIK
Practice Address - State:AK
Practice Address - Zip Code:99763-0189
Practice Address - Country:US
Practice Address - Phone:907-636-2103
Practice Address - Fax:907-636-2195
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK07-940-P172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker