Provider Demographics
NPI:1922453802
Name:DIXON-BROWN, MARIE ST CLAIR (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:ST CLAIR
Last Name:DIXON-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 1:5514 TILDEN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-4715
Mailing Address - Country:US
Mailing Address - Phone:917-498-4330
Mailing Address - Fax:
Practice Address - Street 1:5514 TILDEN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-4715
Practice Address - Country:US
Practice Address - Phone:917-498-4330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY528630-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse