Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 277.000755 | IL |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 209.015961 | IL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 277.000755 | IL |
NPI | 1609303320 |
---|---|
Provider Name | Ms. Brianne C Brown |
First Address | Vernon Hills, IL 60061-1658 |
Second Address | Vernon Hills, IL 60061-1658 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2017 |
Last Update Date | 09/04/2021 |