Healthcare Provider Details

I. General information

NPI: 1609770460
Provider Name (Legal Business Name): MADISON BROWN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5403 SILICA DR
SYLVANIA OH
43560-1981
US

IV. Provider business mailing address

48 FLORENTINE DR
HOLLAND OH
43528-9044
US

V. Phone/Fax

Practice location:
  • Phone: 419-824-8570
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.523683
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: