Provider Demographics
NPI:1255123246
Name:BROWN, AKEIRA RENAE
Entity type:Individual
Prefix:
First Name:AKEIRA
Middle Name:RENAE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 ROOSEVELT ST NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-3142
Mailing Address - Country:US
Mailing Address - Phone:234-430-8438
Mailing Address - Fax:
Practice Address - Street 1:716 ROOSEVELT ST NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-3142
Practice Address - Country:US
Practice Address - Phone:234-430-8438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHVL941663Medicaid