Provider Demographics
NPI:1104658053
Name:BROWN, BEVERLY MARCIA
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:MARCIA
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8304 WADE PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-2970
Mailing Address - Country:US
Mailing Address - Phone:216-939-4015
Mailing Address - Fax:
Practice Address - Street 1:8304 WADE PARK AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-2970
Practice Address - Country:US
Practice Address - Phone:216-939-4015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care