Healthcare Provider Details

I. General information

NPI: 1689511966
Provider Name (Legal Business Name): SIERRA ANN BROWN LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 N BROADWAY ST STE B
GREEN SPRINGS OH
44836-9734
US

IV. Provider business mailing address

422 FLORENCE AVE
FORT WAYNE IN
46808-2456
US

V. Phone/Fax

Practice location:
  • Phone: 844-534-3638
  • Fax:
Mailing address:
  • Phone: 260-237-7406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0812X
TaxonomyCommunity Psychiatric/Mental Health Clinical Nurse Specialist
License Number27079214A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: