Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 95006191 | CA |
NPI | 1013456169 |
---|---|
Provider Name | Brittany Marie Brown |
First Address | Redondo Beach, CA 90277-2917 |
Second Address | Redondo Beach, CA 90277-2917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2017 |
Last Update Date | 21/02/2017 |