Provider Demographics
NPI:1790596773
Name:BROWN, CHONDRA MARIE (TRANSPORTATION)
Entity type:Individual
Prefix:
First Name:CHONDRA
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:TRANSPORTATION
Other - Prefix:
Other - First Name:CHONDRA
Other - Middle Name:MARIE
Other - Last Name:RHODES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:TRANSPORTATION
Mailing Address - Street 1:4225 E MCDOWELL RD APT 1097
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-4456
Mailing Address - Country:US
Mailing Address - Phone:832-540-4313
Mailing Address - Fax:
Practice Address - Street 1:4225 E MCDOWELL RD APT 1097
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-4456
Practice Address - Country:US
Practice Address - Phone:832-540-4313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD11270161172A00000X, 171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No172A00000XOther Service ProvidersDriver