Provider Demographics
NPI:1356920524
Name:BROWN, PAMELA J
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
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 1:8700 FLORIDA BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-4037
Mailing Address - Country:US
Mailing Address - Phone:225-926-9198
Mailing Address - Fax:225-367-1614
Practice Address - Street 1:8700 FLORIDA BLVD STE A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-4037
Practice Address - Country:US
Practice Address - Phone:225-926-9198
Practice Address - Fax:225-367-1614
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA343900000X343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)