Provider Demographics
NPI:1306522826
Name:BROWN, YSHICA
Entity type:Individual
Prefix:
First Name:YSHICA
Middle Name:
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:PO BOX 8506
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44711-8506
Mailing Address - Country:US
Mailing Address - Phone:330-412-2159
Mailing Address - Fax:234-360-3643
Practice Address - Street 1:1429 38TH ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-2442
Practice Address - Country:US
Practice Address - Phone:330-412-2159
Practice Address - Fax:234-360-3643
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health