Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 619547 | TX |
NPI | 1033162102 |
---|---|
Provider Name | Tammy Renee Brown |
First Address | League City, TX 77573-6363 |
Second Address | League City, TX 77573-6363 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 06/11/2007 |