Provider Demographics
NPI:1861999641
Name:BROWN, AMIEE L
Entity type:Individual
Prefix:
First Name:AMIEE
Middle Name:L
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:PO BOX 305
Mailing Address - Street 2:
Mailing Address - City:CANISTOTA
Mailing Address - State:SD
Mailing Address - Zip Code:57012-0305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:341 ASH STREET
Practice Address - Street 2:
Practice Address - City:CANISTOTA
Practice Address - State:SD
Practice Address - Zip Code:57012
Practice Address - Country:US
Practice Address - Phone:605-350-5356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR043279163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergencyGroup - Single Specialty