Provider Demographics
NPI:1528503943
Name:BROWN, MARISSA (RN)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:
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 1:1500 GARDEN ST
Mailing Address - Street 2:6E
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-4492
Mailing Address - Country:US
Mailing Address - Phone:917-981-1208
Mailing Address - Fax:
Practice Address - Street 1:1500 GARDEN ST
Practice Address - Street 2:6E
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-4492
Practice Address - Country:US
Practice Address - Phone:917-981-1208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY725093163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse