Provider Demographics
NPI:1548935018
Name:BROWN, MAURISHA (CNA)
Entity type:Individual
Prefix:MS
First Name:MAURISHA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-3970
Mailing Address - Country:US
Mailing Address - Phone:307-277-9164
Mailing Address - Fax:
Practice Address - Street 1:1415 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-3970
Practice Address - Country:US
Practice Address - Phone:307-277-9164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health