Provider Demographics
NPI:1912605171
Name:BROWN, LINDA DIANNE
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:DIANNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:DIANNE
Other - Last Name:BROWN-JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:51 N DUNDALK AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21222-4224
Mailing Address - Country:US
Mailing Address - Phone:410-558-7163
Mailing Address - Fax:410-522-6060
Practice Address - Street 1:51 N DUNDALK AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21222-4224
Practice Address - Country:US
Practice Address - Phone:410-558-7163
Practice Address - Fax:410-522-6060
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP18690164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse