Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | MD12321 | RI |
N | 208000000X | Pediatrician | MD12321 | RI |
Y | 2080P0204X | Pediatric Emergency Doctor | MD12321 | RI |
NPI | 1518940733 |
---|---|
Provider Name | Linda L Brown |
First Address | Providence, RI 02940-9484 |
Second Address | Providence, RI 02903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 20/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001424340 | (05) | CT |
007059280 | MEDICARE (01) | RI |
06/14/2007 | NHPRI (01) | RI |
12/29/2008 | TUFTS (01) | RI |
414116 | BCBSRI (01) | RI |
939025129 | RI MEDICARE GROUP NUMBER (01) | RI |
H61208 | (02) | |
LB69165 | (05) | RI |