Provider Demographics
NPI:1457245532
Name:BROWN, MATTHEW POWELL
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:POWELL
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX B
Mailing Address - Street 2:
Mailing Address - City:MULLEN
Mailing Address - State:NE
Mailing Address - Zip Code:69152-1550
Mailing Address - Country:US
Mailing Address - Phone:308-636-6066
Mailing Address - Fax:
Practice Address - Street 1:604 SW 3RD ST. PO BOX 209
Practice Address - Street 2:
Practice Address - City:MULLEN
Practice Address - State:NE
Practice Address - Zip Code:69152
Practice Address - Country:US
Practice Address - Phone:308-636-6074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider