Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 1-071969 | AL |
N | 363LP0200X | Nurse Practitioner - Pediatrics | 1-071969 | AL |
N | 363LP2300X | Nurse Practitioner - Primary Care | 1-071969 | AL |
NPI | 1073657748 |
---|---|
Provider Name | Richard Dwayne Brown |
First Address | Birmingham, AL 35233-1711 |
Second Address | Birmingham, AL 35233-1711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1-071969 | RN AND NP LICENSE NUMBER (01) | AL |
1156 | CRNP RX NUMBER (01) | AL |