Provider Demographics
NPI:1962178301
Name:BROWN, SAMANTHA MARIE
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:MARIE
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 1:1629 S ARCH AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4316
Mailing Address - Country:US
Mailing Address - Phone:330-557-5252
Mailing Address - Fax:
Practice Address - Street 1:2012 NOTMAN RD
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:OH
Practice Address - Zip Code:44411-8778
Practice Address - Country:US
Practice Address - Phone:330-557-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care