Provider Demographics
NPI:1730879297
Name:BROWN, ALDA
Entity type:Individual
Prefix:
First Name:ALDA
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 1:14346 STATE HIGHWAY 294
Mailing Address - Street 2:
Mailing Address - City:UPPER SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:43351-9556
Mailing Address - Country:US
Mailing Address - Phone:419-294-2153
Mailing Address - Fax:
Practice Address - Street 1:14346 STATE HIGHWAY 294
Practice Address - Street 2:
Practice Address - City:UPPER SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:43351-9556
Practice Address - Country:US
Practice Address - Phone:419-294-2153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health