Individual ProviderNicole BrownCase Manager/Care CoordinatorOther Service ProvidersPractice Address1102 Commercial Dr, Hammond, LA 70403-5954(985) 662-3799PECOS EnrollmentBased on the most recent information from CMS, provider Nicole Brown does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 7 days ago.Profile DetailsProvider ID1477190536Provider TypeIndividualFull NameBrown, NicoleGenderFemaleSole ProprietorYesEnumeration Date12/6/2019Last Updated12/6/2019Contact InformationPractice LocationPractice Address1102 Commercial Dr, Hammond, LA 70403-5954Phone(985) 662-3799Fax(985) 662-3829Mailing LocationMailing Address1102 Commercial Dr, Hammond, LA 70403-5954Phone(985) 662-3799FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerLouisianaProvider IdentifiersIDDescriptionIssuerID1366728420DescriptionMedicaidIssuerUnlistedLouisiana