Healthcare Provider Details

I. General information

NPI: 1629993142
Provider Name (Legal Business Name): BRENDA J BROWN-ALEXANDER CHW, QBHS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 BOWMAN ST
MANSFIELD OH
44903-1235
US

IV. Provider business mailing address

106 CARPENTER RD APT 4
MANSFIELD OH
44903-2271
US

V. Phone/Fax

Practice location:
  • Phone: 419-525-3525
  • Fax: 419-525-3538
Mailing address:
  • Phone: 419-525-3525
  • Fax: 419-525-3538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number000065
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: