Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 328792 | CA |
NPI | 1003925371 |
---|---|
Provider Name | Janice A. Brown |
First Address | Bakersfield, CA 93305-4144 |
Second Address | Bakersfield, CA 93305-4144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
328792 | NP LICENSE (01) | CA |