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General NPI Number Information
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NPI Number | 1609115278
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Entity Type | Individual
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Provider Name | STEPHANIE KENYATTA BROWN CPT
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Gender | Female
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Dates
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Enumeration Date | 02/01/2013
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 18121 E 8 MILE RD STE 330
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City | EASTPOINTE
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State | MI
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Zip | 48021-3245
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Country | US
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Telephone | 313-288-0451
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Fax |
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Provider Business Mailing Address
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Address Line | 11931 GREINER ST
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City | DETROIT
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State | MI
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Zip | 48205-2609
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Country | US
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Telephone | 313-408-7753
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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 | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 246YC3302X
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Taxonomy Name | Physician Office Based Coding Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 23D2302134
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 246R00000X
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Taxonomy Name | Pathology Technician
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License Number |
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License Number State | MI
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