Healthcare Provider Details

I. General information

NPI: 1134567621
Provider Name (Legal Business Name): SHERINA SHONTEA BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHERINA SHONTEA BROWN

II. Dates (important events)

Enumeration Date: 06/06/2013
Last Update Date: 05/05/2023
Certification Date: 05/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3516 13TH ST SE APT 101
WASHINGTON DC
20032-4426
US

IV. Provider business mailing address

7626 EASTERN AVENUNE NW LL16
WAHINGTON DC
20012
US

V. Phone/Fax

Practice location:
  • Phone: 202-321-5912
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: