MEDICARE: APPOLONIA PATRICE BROWN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	400930980609	OH

General Provider Information

NPI Number	:	1164964136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	APPOLONIA PATRICE BROWN

Provider Business Mailing Address
First Line	:	4231 FAIRVIEW DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43612-1832
Country	:	US
Telephone Number	:	419-503-4226
Fax Number	:

Provider Business Practice Location Address
First Line	:	4231 FAIRVIEW DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43612-1832
Country	:	US
Telephone Number	:	419-503-4226
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2016
Last Update Date	:	11/08/2016

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Directions to “ APPOLONIA PATRICE BROWN ” Practice Location

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