Provider Demographics
NPI:1174090492
Name:BROWNLEE, REBECCA JEAN (RN BSN)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:JEAN
Last Name:BROWNLEE
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:JEAN
Other - Last Name:BERRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1415 VICTORIA ST APT 1404
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-3663
Mailing Address - Country:US
Mailing Address - Phone:517-581-7274
Mailing Address - Fax:
Practice Address - Street 1:1415 VICTORIA ST APT 1404
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-3663
Practice Address - Country:US
Practice Address - Phone:517-581-7274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704233579163W00000X
HI88893163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse