MEDICARE: LATASHIA 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1578345146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATASHIA BROWN

Provider Business Mailing Address
First Line	:	1165 BLANKENSHIP AVE # 13
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-2220
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 WINTERHAVEN ST APT 225
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-5068
Country	:	US
Telephone Number	:	725-724-7847
Fax Number	:

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

Provider Enumeration Date	:	10/18/2023
Last Update Date	:	10/18/2023

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Directions to “ LATASHIA BROWN ” Practice Location

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