Provider Demographics
NPI:1699578104
Name:BROWN, ONTIRRIA
Entity type:Individual
Prefix:
First Name:ONTIRRIA
Middle Name:
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 1:11203 CRIPPEN CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68138-4316
Mailing Address - Country:US
Mailing Address - Phone:402-670-7577
Mailing Address - Fax:
Practice Address - Street 1:11203 CRIPPEN CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68138-4316
Practice Address - Country:US
Practice Address - Phone:402-670-7577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion