Provider Demographics
NPI:1609684901
Name:BROWN, SANDRA ANETA (OWNER)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:ANETA
Last Name:BROWN
Suffix:
Gender:F
Credentials:OWNER
Other - Prefix:MRS
Other - First Name:FRANIZISE
Other - Middle Name:
Other - Last Name:QUERETTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:184 LAUREL PL
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06604-1718
Mailing Address - Country:US
Mailing Address - Phone:475-319-5187
Mailing Address - Fax:
Practice Address - Street 1:186 LAUREL PL
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-1718
Practice Address - Country:US
Practice Address - Phone:475-319-5187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker