Healthcare Provider Details

I. General information

NPI: 1568309615
Provider Name (Legal Business Name): CARMEN VICTORIA BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1143 XENIA AVE APT A
YELLOW SPRINGS OH
45387-1102
US

IV. Provider business mailing address

1143 XENIA AVE APT A
YELLOW SPRINGS OH
45387-1102
US

V. Phone/Fax

Practice location:
  • Phone: 937-408-5766
  • Fax:
Mailing address:
  • Phone: 937-408-5766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: