Provider Demographics
NPI:1194439448
Name:BROWN, WHITLI RACHELLE
Entity type:Individual
Prefix:
First Name:WHITLI
Middle Name:RACHELLE
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 1:98 ACME ST APT 6
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-3380
Mailing Address - Country:US
Mailing Address - Phone:304-966-3476
Mailing Address - Fax:
Practice Address - Street 1:98 ACME ST APT 6
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3380
Practice Address - Country:US
Practice Address - Phone:304-966-3476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant