Heidi Davonne Brown, LPN, CMLD, CEO

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

27075427A Issued in IN

Practice address

2918 Bonds Ave
South Bend, IN 46628-1957

Phone

(866) 350-6400

NPI assigned

Feb 20, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eminence Healthcare Staffing Agency LLC.

  dba Eminence Health & Notary Services

  • Clinical Medical Laboratory
  • South Bend, IN
  • NPI 1720588221

  Licensed Practical Nurse

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1356841944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2918 BONDS AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466281957",
            "telephone_number": "866-350-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2918 BONDS AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466281957",
            "telephone_number": "866-350-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6140 Brockworth Dr Apt B",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462036280",
            "country_code": "US",
            "telephone_number": "765-631-9016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "HEIDI",
        "middle_name": "DAVONNE",
        "credential": "LPN, CMLD, CEO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-20",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "IN",
            "license": "15D2213193",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "IN",
            "license": "27075427A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi Lea Brown, CPNP-AC
• Clarissa Brown
• Dante Jerome Brown, D.M.D
• Eric Brown, RBT
• Eric Q Brown, MSW
• Jacqueline Brown, LCSW
• Lisa A Brown, MS
• Marijke M Brown, LCSW
• Tecora Brown
• Toni Brown, NP

• Licensed Practical Nurse in South Bend, IN
• Providers in South Bend, IN by specialty
• Licensed Practical Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.