Provider Demographics
NPI:1700541554
Name:BROWN, JAMES NATHAN JR
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:NATHAN
Last Name:BROWN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4312 SWAN LAKE DR LOT 13
Mailing Address - Street 2:
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010-9377
Mailing Address - Country:US
Mailing Address - Phone:269-348-2973
Mailing Address - Fax:
Practice Address - Street 1:4312 SWAN LAKE DR LOT 13
Practice Address - Street 2:
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-9377
Practice Address - Country:US
Practice Address - Phone:269-348-2973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-06
Last Update Date:2021-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide