Healthcare Provider Details

I. General information

NPI: 1063306991
Provider Name (Legal Business Name): SANTANA BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 ROSE ST
LINCOLN NE
68502-2145
US

IV. Provider business mailing address

835 ROSE ST
LINCOLN NE
68502-2145
US

V. Phone/Fax

Practice location:
  • Phone: 402-601-9212
  • Fax: 402-601-9212
Mailing address:
  • Phone: 402-601-9212
  • Fax: 402-601-9212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberFI12636
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberFI12636
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: