Provider Demographics
NPI:1992205652
Name:BROWN, DANA
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 BONNABEL BLVD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-1539
Mailing Address - Country:US
Mailing Address - Phone:504-111-1111
Mailing Address - Fax:504-558-4937
Practice Address - Street 1:1241 BONNABEL BLVD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-1539
Practice Address - Country:US
Practice Address - Phone:504-111-1111
Practice Address - Fax:504-558-4937
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-19
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty