Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 1-121635 | AL |
NPI | 1063978336 |
---|---|
Provider Name | Allison Nicole Brown |
First Address | Huntsville, AL 35805-4104 |
Second Address | Huntsville, AL 35805-4104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2019 |
Last Update Date | 12/02/2019 |