Provider Demographics
NPI:1295932606
Name:SHARON BROWN
Entity type:Organization
Organization Name:SHARON BROWN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:702-871-1465
Mailing Address - Street 1:7513 ELK MEADOWS CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-3200
Mailing Address - Country:US
Mailing Address - Phone:702-871-1465
Mailing Address - Fax:702-871-1465
Practice Address - Street 1:7513 ELK MEADOWS CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-3200
Practice Address - Country:US
Practice Address - Phone:702-871-1465
Practice Address - Fax:702-871-1465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNVMT 206225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV22OtherRAHABILITATIVE SERVICES