Provider Demographics
NPI:1063306991
Name:BROWN, SANTANA
Entity type:Individual
Prefix:
First Name:SANTANA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-2145
Mailing Address - Country:US
Mailing Address - Phone:402-601-9212
Mailing Address - Fax:402-601-9212
Practice Address - Street 1:835 ROSE ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-2145
Practice Address - Country:US
Practice Address - Phone:402-601-9212
Practice Address - Fax:402-601-9212
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEFI12636253Z00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No253Z00000XAgenciesIn Home Supportive Care