Provider Demographics
NPI:1316672389
Name:BROWN, BEVERLY JANA (CNA)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:JANA
Last Name:BROWN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50315-3453
Mailing Address - Country:US
Mailing Address - Phone:515-991-0184
Mailing Address - Fax:
Practice Address - Street 1:1220 LEWIS AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50315-3453
Practice Address - Country:US
Practice Address - Phone:515-991-0184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-22
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health