Provider Demographics
NPI:1528488764
Name:BROWN, SHALA LENEE (RN)
Entity type:Individual
Prefix:MRS
First Name:SHALA
Middle Name:LENEE
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 14TH ST SE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44707
Mailing Address - Country:US
Mailing Address - Phone:330-456-1189
Mailing Address - Fax:330-580-2404
Practice Address - Street 1:401 14TH ST SE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44707
Practice Address - Country:US
Practice Address - Phone:330-456-1189
Practice Address - Fax:330-580-2404
Is Sole Proprietor?:No
Enumeration Date:2014-04-25
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN285531163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool