Healthcare Provider Details

I. General information

NPI: 1982455358
Provider Name (Legal Business Name): KASHEEMA BROWN LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 WOODLAND HEIGHTS RD
LITTLE ROCK AR
72212-2495
US

IV. Provider business mailing address

3920 WOODLAND HEIGHTS RD
LITTLE ROCK AR
72212-2495
US

V. Phone/Fax

Practice location:
  • Phone: 501-227-3610
  • Fax: 501-227-3601
Mailing address:
  • Phone: 501-227-3610
  • Fax: 501-227-3601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberL060388
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: