Healthcare Provider Details

I. General information

NPI: 1255076923
Provider Name (Legal Business Name): SHAWNTA' PULLIAM-BROWN BCNWP, CD(DONA)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2022
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4906 RICHMOND ST
ERIE PA
16509-1978
US

IV. Provider business mailing address

3612 BRANDES ST
ERIE PA
16504-3002
US

V. Phone/Fax

Practice location:
  • Phone: 814-299-9550
  • Fax:
Mailing address:
  • Phone: 814-460-3205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number14594
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: