Provider Demographics
NPI:1851062772
Name:BROWN, STEPHANIE MICHELLE (RN)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MICHELLE
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:PO BOX 46
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12791-0046
Mailing Address - Country:US
Mailing Address - Phone:845-701-3799
Mailing Address - Fax:
Practice Address - Street 1:60 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-1122
Practice Address - Country:US
Practice Address - Phone:845-764-5095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY551467163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program