Individual
DAPHANE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
340 STATELINE RD W, SOUTHAVEN, MS 38671-1610
(661) 510-5387
Mailing address
9400 GOODMAN RD APT 3721, OLIVE BRANCH, MS 38654-1979
(901) 652-7443
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
329501
MS
Other
Enumeration date
06/04/2021
Last updated
06/04/2021
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