=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043442262
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEBORAH ANN BROWN L.P.N.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/21/2009
-----------------------------------------------------
Last Update Date | 08/21/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 144 S 2ND AVE APT 2E 2E
-----------------------------------------------------
City | MOUNT VERNON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10550-3524
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-664-2288
-----------------------------------------------------
Fax | 914-664-2288
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 144 S 2ND AVE APT 2E
-----------------------------------------------------
City | MOUNT VERNON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10550-3524
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-664-2288
-----------------------------------------------------
Fax | 914-664-2288
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 164W00000X
-----------------------------------------------------
Taxonomy Name | Licensed Practical Nurse
-----------------------------------------------------
License Number | 164412-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------