MEDICARE: CHANELLE OSLEY-BROWN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1114275005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANELLE OSLEY-BROWN

Provider Business Mailing Address
First Line	:	2642 BERMUDA LAKE DR
Second Line	:	APT. 202B
City	:	BRANDON
State	:	FL
Zip	:	33510-2489
Country	:	US
Telephone Number	:	813-546-2608
Fax Number	:	813-490-5495

Provider Business Practice Location Address
First Line	:	2642 BERMUDA LAKE DR
Second Line	:	APT. 202B
City	:	BRANDON
State	:	FL
Zip	:	33510-2489
Country	:	US
Telephone Number	:	813-546-2608
Fax Number	:	813-490-5495

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2012
Last Update Date	:	08/27/2012

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Directions to “ CHANELLE OSLEY-BROWN ” Practice Location

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