Provider Demographics
NPI:1831790401
Name:BROWN, JANICE L (NURSE AIDE)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:L
Last Name:BROWN
Suffix:
Gender:F
Credentials:NURSE AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2619 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70615-3678
Mailing Address - Country:US
Mailing Address - Phone:337-526-5793
Mailing Address - Fax:
Practice Address - Street 1:2619 CHURCH ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70615-3678
Practice Address - Country:US
Practice Address - Phone:337-526-5793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA106339376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide