Provider Demographics
NPI:1316068125
Name:BROWN, IZASKUN YVONNE (COHC)
Entity type:Individual
Prefix:MS
First Name:IZASKUN
Middle Name:YVONNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:COHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3259 CATLIN AVE
Mailing Address - Street 2:NAVAL HEALTH CLINIC QUANTICO, DEPLOYMENT HEALTH CLINIC
Mailing Address - City:QUANTICO
Mailing Address - State:VA
Mailing Address - Zip Code:22134-0020
Mailing Address - Country:US
Mailing Address - Phone:703-784-1730
Mailing Address - Fax:
Practice Address - Street 1:3259 CATLIN AVE
Practice Address - Street 2:NAVAL HEALTH CLINIC QUANTICO, DEPLOYMENT HEALTH CLINIC
Practice Address - City:QUANTICO
Practice Address - State:VA
Practice Address - Zip Code:22134-5109
Practice Address - Country:US
Practice Address - Phone:703-784-1730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1710I1003X, 171000000X, 247200000X
VA490166246Z00000X
VA204112N246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
No1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians
No171000000XOther Service ProvidersMilitary Health Care Provider
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other