Provider Demographics
NPI:1962142729
Name:BROWN, AVIS YVONNE (MASTERS)
Entity type:Individual
Prefix:MS
First Name:AVIS
Middle Name:YVONNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1585 EDDIE WOODS ROAD
Mailing Address - Street 2:
Mailing Address - City:GREELEYVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29056
Mailing Address - Country:US
Mailing Address - Phone:843-356-8785
Mailing Address - Fax:
Practice Address - Street 1:82 NORTH MAIN STREET
Practice Address - Street 2:82 NORTH MAIN STREET SUITE A/B
Practice Address - City:GREELEYVILLE
Practice Address - State:SC
Practice Address - Zip Code:29056
Practice Address - Country:US
Practice Address - Phone:843-356-8785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health