Provider Demographics
NPI:1265784128
Name:BROWN, SAMUEL ARTHUR (RN)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:ARTHUR
Last Name:BROWN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13846 NICKEL PLATE RD
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:OH
Mailing Address - Zip Code:43138-9040
Mailing Address - Country:US
Mailing Address - Phone:740-603-6731
Mailing Address - Fax:
Practice Address - Street 1:13846 NICKEL PLATE RD
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:OH
Practice Address - Zip Code:43138-9040
Practice Address - Country:US
Practice Address - Phone:740-603-6731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH378951163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse