Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 295702 | CA |
NPI | 1003997248 |
---|---|
Provider Name | Ms. Linda Rose Brown |
First Address | Roseville, CA 95661-3027 |
Second Address | Roseville, CA 95661-3027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 09/07/2007 |