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General NPI Number Information
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NPI Number | 1245021724
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Entity Type | Individual
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Provider Name | MRS. WANDA LEE-KAY BROWN
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Gender | Female
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 650 E INDIAN SCHOOL RD
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City | PHOENIX
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State | AZ
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Zip | 85012-1839
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Country | US
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Telephone | 602-277-5551
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Fax |
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Provider Business Mailing Address
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Address Line | 333 EVERGREEN CIR
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City | PICKERINGTON
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State | OH
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Zip | 43147-8090
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Country | US
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Telephone | 614-531-0775
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.469103
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License Number State | OH
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