MEDICARE: CAROLE 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
1	164W00000X	Licensed Practical Nurse	4703014984	MI

General Provider Information

NPI Number	:	1477995116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLE BROWN LPN

Provider Business Mailing Address
First Line	:	955 W BROADWAY AVE
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49441-3521
Country	:	US
Telephone Number	:	231-755-0637
Fax Number	:	231-755-6208

Provider Business Practice Location Address
First Line	:	955 W BROADWAY AVE
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49441-3521
Country	:	US
Telephone Number	:	231-755-0637
Fax Number	:	231-755-6208

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

Provider Enumeration Date	:	07/23/2013
Last Update Date	:	05/24/2026

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