MEDICARE: MS. ADRIENNE C BROWN LM, CPM

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	176B00000X	Midwife	7822984-3400	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386649309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ADRIENNE C BROWN LM, CPM

Provider Business Mailing Address
First Line	:	6440 S WASATCH BLVD STE 140
Second Line	:
City	:	HOLLADAY
State	:	UT
Zip	:	84121-3539
Country	:	US
Telephone Number	:	435-633-3626
Fax Number	:	801-281-9923

Provider Business Practice Location Address
First Line	:	6440 S WASATCH BLVD STE 140
Second Line	:
City	:	HOLLADAY
State	:	UT
Zip	:	84121
Country	:	US
Telephone Number	:	435-633-3626
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	05/18/2018

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