Provider Demographics
NPI:1114546462
Name:BROWN, NEHEMIAH LEVI
Entity type:Individual
Prefix:
First Name:NEHEMIAH
Middle Name:LEVI
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SARA FOX DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-5527
Mailing Address - Country:US
Mailing Address - Phone:601-672-6617
Mailing Address - Fax:
Practice Address - Street 1:111 SARA FOX DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39047-5527
Practice Address - Country:US
Practice Address - Phone:601-672-6617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-15
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier