MEDICARE: REBECCA BROWN

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	3747P1801X	Personal Care Attendant
2	376J00000X	Homemaker
3	3747A0650X	Attendant Care Provider

General Provider Information

NPI Number	:	1487128724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA BROWN

Provider Business Mailing Address
First Line	:	2802 LAURIE DR
Second Line	:
City	:	WEST PLAINS
State	:	MO
Zip	:	65775-1563
Country	:	US
Telephone Number	:	417-293-6831
Fax Number	:

Provider Business Practice Location Address
First Line	:	408 WASHINGTON AVE STE 103
Second Line	:
City	:	WEST PLAINS
State	:	MO
Zip	:	65775-3404
Country	:	US
Telephone Number	:	417-204-0073
Fax Number	:	417-255-8799

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

Provider Enumeration Date	:	01/21/2019
Last Update Date	:	05/23/2019

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Directions to “ REBECCA BROWN ” Practice Location

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