Provider Demographics
NPI:1114713468
Name:BROWN, EVERETT NEAL JR
Entity type:Individual
Prefix:MR
First Name:EVERETT
Middle Name:NEAL
Last Name:BROWN
Suffix:JR
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 36TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-2601
Mailing Address - Country:US
Mailing Address - Phone:240-886-8680
Mailing Address - Fax:
Practice Address - Street 1:122 36TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-2601
Practice Address - Country:US
Practice Address - Phone:240-886-8680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant