Provider Demographics
NPI:1669933396
Name:BROWN, DONESHIA
Entity type:Individual
Prefix:
First Name:DONESHIA
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 1:1436 SAINT ANDREWS LN
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-1613
Mailing Address - Country:US
Mailing Address - Phone:662-694-2179
Mailing Address - Fax:662-332-4062
Practice Address - Street 1:1436 SAINT ANDREWS LN
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-1613
Practice Address - Country:US
Practice Address - Phone:662-694-2179
Practice Address - Fax:662-332-4062
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744G0900XOther Service ProvidersSpecialistGraphics Designer
No174400000XOther Service ProvidersSpecialist
No1744R1102XOther Service ProvidersSpecialistResearch Study