Provider Demographics
NPI:1700317641
Name:BROWN-BURRELL, SALOME G (RN)
Entity type:Individual
Prefix:MRS
First Name:SALOME
Middle Name:G
Last Name:BROWN-BURRELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SALOME
Other - Middle Name:G
Other - Last Name:BROWN-BURRELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:1101 PARR MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1177
Mailing Address - Country:US
Mailing Address - Phone:845-561-5812
Mailing Address - Fax:
Practice Address - Street 1:1101 PARR MEADOW DR
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1177
Practice Address - Country:US
Practice Address - Phone:845-561-5812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22499619372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider