Provider Demographics
NPI:1700695129
Name:BROWN, ANITA LYNN
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:LYNN
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 1:65 ROYAL MALL DR
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-3243
Mailing Address - Country:US
Mailing Address - Phone:330-707-7780
Mailing Address - Fax:
Practice Address - Street 1:65 ROYAL MALL DR
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-3243
Practice Address - Country:US
Practice Address - Phone:330-707-7780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health