Healthcare Provider Details

I. General information

NPI: 1568382539
Provider Name (Legal Business Name): ANNABELL MARIE BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 SLEEPY HOLLOW LOOP
GRANTS PASS OR
97527-9585
US

IV. Provider business mailing address

375 SLEEPY HOLLOW LOOP
GRANTS PASS OR
97527-9585
US

V. Phone/Fax

Practice location:
  • Phone: 541-787-7185
  • Fax:
Mailing address:
  • Phone: 541-787-7185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH9290
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: