Provider Demographics
NPI:1922371053
Name:BROWN, ANDREA N (LPN)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:N
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 1:26011 LAKESHORE BLVD
Mailing Address - Street 2:STE 801
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26011 LAKE SHORE BLVD
Practice Address - Street 2:STE 801
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-1175
Practice Address - Country:US
Practice Address - Phone:216-712-8509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH118322164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse