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NPI Code Detail

MEDICARE: JOANNA GRACE BROWN LPN

MEDICARE:   JOANNA GRACE BROWN  LPN
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
1164W00000XLicensed Practical NursePN5231663FL

General Provider Information

NPI Number : 1114774999
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANNA GRACE BROWN LPN
Provider Business Mailing Address
First Line : 7311 STATE HIGHWAY 2 W
Second Line :
City : DEFUNIAK SPRINGS
State : FL
Zip : 32433-5890
Country : US
Telephone Number : 850-240-2012
Fax Number :
Provider Business Practice Location Address
First Line : 7311 STATE HIGHWAY 2 W
Second Line :
City : DEFUNIAK SPRINGS
State : FL
Zip : 32433-5890
Country : US
Telephone Number : 850-240-2012
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2024
Last Update Date : 05/01/2024

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Directions to “ JOANNA GRACE BROWN LPN” Practice Location

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