MEDICARE: MARSHA ANN 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	171W00000X	Contractor		NE

General Provider Information

NPI Number	:	1154138238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARSHA ANN BROWN

Provider Business Mailing Address
First Line	:	806 S EAST ST
Second Line	:
City	:	VALLEY
State	:	NE
Zip	:	68064-9772
Country	:	US
Telephone Number	:	402-680-8760
Fax Number	:

Provider Business Practice Location Address
First Line	:	806 S EAST ST
Second Line	:
City	:	VALLEY
State	:	NE
Zip	:	68064-9772
Country	:	US
Telephone Number	:	402-680-8760
Fax Number	:

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

Provider Enumeration Date	:	12/12/2024
Last Update Date	:	12/12/2024

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