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NPI Code Detail

MEDICARE: EBONEE MARLENE BROWN RN

MEDICARE: EBONEE MARLENE BROWN RN
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 Nurse279559-1NY
2163W00000XRegistered Nurse794763-01NY

General Provider Information

NPI Number : 1538472063
Entity Type Code : Individual
Provider Name (Legal Business Name) : EBONEE MARLENE BROWN RN
Provider Business Mailing Address
First Line : 8 HARVEST HILL LN
Second Line : MIDDLETOWN
City : MIDDLETOWN
State : NY
Zip : 10940-2614
Country : US
Telephone Number : 347-236-9382
Fax Number :
Provider Business Practice Location Address
First Line : 8 HARVEST HILL LANE
Second Line : PRIVATE HOUSE
City : MIDDLETOWN
State : NY
Zip : 10940-0000
Country : US
Telephone Number : 347-236-9382
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2010
Last Update Date : 09/30/2021

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