Basic Information
| Provider Information | |||||||||
| NPI: | 1679178446 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | SONOBI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8670 W CHEYENNE AVE STE 135 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891297460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028832686 | ||||||||
| FaxNumber: | 7028221910 | ||||||||
| Practice Location | |||||||||
| Address1: | 8670 W CHEYENNE AVE STE 135 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891297460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028832686 | ||||||||
| FaxNumber: | 7028221910 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2020 | ||||||||
| LastUpdateDate: | 12/01/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 374U00000X | Y | Nursing Service Related Providers | Home Health Aide |
No ID Information.