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Individual

TAWANA BROWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
824 PORTSMOUTH AVE, WESTCHESTER, IL 60154-2607
(877) 522-2288
Mailing address
5509 W CHEYENNE AVE APT B, LAS VEGAS, NV 89108-4784
(702) 900-0532

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00002615163
IL
05
00002615163
NV
Enumeration date
11/28/2022
Last updated
03/21/2025
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