MEDICARE: MS. PATRICIA BROWN STNA

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	311ZA0620X	Adult Care Home Facility	400314931203	OH
2	376K00000X	Nurse's Aide	400314931203	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	313246283301	OTHER	OH	MEDICARE NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316283088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA BROWN STNA

Provider Business Mailing Address
First Line	:	10285 FAXON CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-1006
Country	:	US
Telephone Number	:	513-772-2159
Fax Number	:

Provider Business Practice Location Address
First Line	:	10285 FAXON CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-1006
Country	:	US
Telephone Number	:	513-772-2159
Fax Number	:

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

Provider Enumeration Date	:	12/27/2012
Last Update Date	:	12/27/2012

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Directions to “ MS. PATRICIA BROWN STNA” Practice Location

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