Healthcare Provider Details

I. General information

NPI: 1467316141
Provider Name (Legal Business Name): NIQUOYA BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15045 BROOKVIEW DR APT 102
RIVERVIEW MI
48193-8040
US

IV. Provider business mailing address

15045 BROOKVIEW DR APT 102
RIVERVIEW MI
48193-8040
US

V. Phone/Fax

Practice location:
  • Phone: 248-808-9582
  • Fax:
Mailing address:
  • Phone: 248-808-9582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: