Healthcare Provider Details

I. General information

NPI: 1790617041
Provider Name (Legal Business Name): SHAWANNAH BROWN ELDER CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

682 CREEKSTONE CIR
MEMPHIS TN
38127-2051
US

IV. Provider business mailing address

682 CREEKSTONE CIR
MEMPHIS TN
38127-2051
US

V. Phone/Fax

Practice location:
  • Phone: 901-671-6607
  • Fax:
Mailing address:
  • Phone: 901-671-6607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHAWANNAH R BROWN
Title or Position: HOME HEALTH MANAGER
Credential: BLS) & CPR CERTIFICA
Phone: 901-647-9465