MEDICARE: LATANYA R 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	376J00000X	Homemaker

General Provider Information

NPI Number	:	1184352916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATANYA R BROWN

Provider Business Mailing Address
First Line	:	1563 CAMPUS DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45406-4529
Country	:	US
Telephone Number	:	937-829-9292
Fax Number	:

Provider Business Practice Location Address
First Line	:	1563 CAMPUS DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45406-4529
Country	:	US
Telephone Number	:	937-829-9292
Fax Number	:

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

Provider Enumeration Date	:	08/10/2022
Last Update Date	:	08/10/2022

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Directions to “ LATANYA R BROWN ” Practice Location

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