Provider Demographics
NPI:1336947969
Name:BROWN, SHENEATRON YVETTE
Entity type:Individual
Prefix:
First Name:SHENEATRON
Middle Name:YVETTE
Last Name:BROWN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2823 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68147-1429
Mailing Address - Country:US
Mailing Address - Phone:402-203-1604
Mailing Address - Fax:
Practice Address - Street 1:2823 HARRISON ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68147-1429
Practice Address - Country:US
Practice Address - Phone:402-203-1604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE464031Medicaid