Healthcare Provider Details

I. General information

NPI: 1225947989
Provider Name (Legal Business Name): NENA BROWN LMT 2204
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 JONES LN STE A
FLOWOOD MS
39232-8899
US

IV. Provider business mailing address

707 COLONY PARK DR
PEARL MS
39208-6287
US

V. Phone/Fax

Practice location:
  • Phone: 601-622-7503
  • Fax:
Mailing address:
  • Phone: 601-724-2074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number2204
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: