Provider Demographics
NPI:1922737493
Name:BROWNLEE, ANGELA K (CNA)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:K
Last Name:BROWNLEE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10207 LYNNCREST CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-3214
Mailing Address - Country:US
Mailing Address - Phone:314-335-9844
Mailing Address - Fax:
Practice Address - Street 1:3514 OREGON AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63118-3804
Practice Address - Country:US
Practice Address - Phone:314-335-9844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO82521A374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide