Provider Demographics
NPI:1336423136
Name:BROWN, SHAUNA LOUISE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SHAUNA
Middle Name:LOUISE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 E 50TH ST
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-4914
Mailing Address - Country:US
Mailing Address - Phone:918-231-4762
Mailing Address - Fax:
Practice Address - Street 1:1605 W 7TH ST
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64801-3071
Practice Address - Country:US
Practice Address - Phone:417-659-8453
Practice Address - Fax:417-624-2586
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009025145183500000X
OK14521183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist