Provider Demographics
NPI:1184409278
Name:BROWN, CALLY LYNN
Entity type:Individual
Prefix:
First Name:CALLY
Middle Name:LYNN
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 1:41 DEHOFF DR
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2403
Mailing Address - Country:US
Mailing Address - Phone:330-507-1271
Mailing Address - Fax:
Practice Address - Street 1:41 DEHOFF DR
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2403
Practice Address - Country:US
Practice Address - Phone:330-507-1271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant