Provider Demographics
NPI:1992269328
Name:BROWN, ANGELA AMY (BSN, RN)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:AMY
Last Name:BROWN
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 5TH ST
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-1830
Mailing Address - Country:US
Mailing Address - Phone:509-290-8987
Mailing Address - Fax:
Practice Address - Street 1:12414 S ANDRUS RD
Practice Address - Street 2:
Practice Address - City:CHENEY
Practice Address - State:WA
Practice Address - Zip Code:99004-8607
Practice Address - Country:US
Practice Address - Phone:509-559-4599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60221132163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool