Provider Demographics
NPI:1982095733
Name:BROWN, WESLEE (RN)
Entity type:Individual
Prefix:
First Name:WESLEE
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 1:19940 CONANT ST
Mailing Address - Street 2:A, B, C
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234-1494
Mailing Address - Country:US
Mailing Address - Phone:904-376-0024
Mailing Address - Fax:
Practice Address - Street 1:19940 CONANT ST
Practice Address - Street 2:A, B, C
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-1494
Practice Address - Country:US
Practice Address - Phone:904-376-0024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704310412163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse