MEDICARE: SUSAN STEWART BROWN HEALTH COACH

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	171400000X	Health & Wellness Coach		NY

General Provider Information

NPI Number	:	1568248599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN STEWART BROWN HEALTH COACH

Provider Business Mailing Address
First Line	:	6027 CANNON HILL RD
Second Line	:
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-1822
Country	:	US
Telephone Number	:	126-735-5375
Fax Number	:

Provider Business Practice Location Address
First Line	:	6027 CANNON HILL RD
Second Line	:
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-1822
Country	:	US
Telephone Number	:	267-355-3758
Fax Number	:

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

Provider Enumeration Date	:	09/06/2023
Last Update Date	:	09/06/2023

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