Healthcare Provider Details

I. General information

NPI: 1689070633
Provider Name (Legal Business Name): NAKESHA NACOLE BROWN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2014
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3310 W COMMERCE RD
MILFORD MI
48380-3100
US

IV. Provider business mailing address

15819 SCHOOLCRAFT STREET
DETROIT MI
48227-1749
US

V. Phone/Fax

Practice location:
  • Phone: 313-720-7895
  • Fax: 248-256-3801
Mailing address:
  • Phone: 248-508-2920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704255958
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704255958
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: