MEDICARE: KELLY HADNOTT-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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1174034037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY HADNOTT-BROWN

Provider Business Mailing Address
First Line	:	4517 MONT EAGLE PL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-3418
Country	:	US
Telephone Number	:	323-455-4915
Fax Number	:

Provider Business Practice Location Address
First Line	:	4515 MONT EAGLE PL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-3418
Country	:	US
Telephone Number	:	323-455-4915
Fax Number	:	323-255-8484

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

Provider Enumeration Date	:	10/18/2017
Last Update Date	:	10/18/2017

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Directions to “ KELLY HADNOTT-BROWN ” Practice Location

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