Provider Demographics
NPI:1568270239
Name:BROWN, BOBBI LYN
Entity type:Individual
Prefix:
First Name:BOBBI
Middle Name:LYN
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4834 S 23RD ST APT 414
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-2872
Mailing Address - Country:US
Mailing Address - Phone:402-885-3034
Mailing Address - Fax:
Practice Address - Street 1:2014 CALHOUN ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-3218
Practice Address - Country:US
Practice Address - Phone:402-614-6263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant