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General NPI Number Information
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NPI Number | 1619628435
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Entity Type | Individual
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Provider Name | TARANEISHEA BROWN
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Gender | Female
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Dates
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Enumeration Date | 01/13/2022
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Last Update Date | 01/13/2022
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Provider Practice Location Address
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Address Line | 801 NORTHPOINT PKWY STE 74
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-1812
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Country | US
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Telephone | 561-619-0796
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Fax |
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Provider Business Mailing Address
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Address Line | 4725 HOLLY LAKE DR
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City | LAKE WORTH
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State | FL
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Zip | 33463-5374
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Country | US
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Telephone | 561-932-5231
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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 | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number |
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License Number State |
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