MEDICARE: BROWN AND ASSOCIATES HEALTHCARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	AP123961	TX

General Provider Information

NPI Number	:	1316430846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROWN AND ASSOCIATES HEALTHCARE INC

Provider Business Mailing Address
First Line	:	3148 SERPIS
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75054-6730
Country	:	US
Telephone Number	:	972-639-3343
Fax Number	:

Provider Business Practice Location Address
First Line	:	2305 OAK LN STE 106
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75051-8243
Country	:	US
Telephone Number	:	972-639-3343
Fax Number	:	972-449-0490

Authorized Official
Title or Position	:	CEO
Name	:	NICOLE BROWN
Credential	:	FNP
Telephone Number	:	972-639-3343

Provider Enumeration Date	:	06/09/2018
Last Update Date	:	06/09/2018

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