Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 200250080NP | OR |
NPI | 1033190830 |
---|---|
Provider Name | Esther Eugenia Brown |
First Address | Salem, OR 97303-0900 |
Second Address | Salem, OR 97301-4693 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 20/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
080234 | (05) | OR |
P69246 | (02) | OR |