Healthcare Provider Details

I. General information

NPI: 1245908292
Provider Name (Legal Business Name): JOSEPH BROWN APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2021
Last Update Date: 09/03/2021
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5830 HIGHWAY 5
CABOT AR
72023-7328
US

IV. Provider business mailing address

PO BOX 497
AUGUSTA AR
72006-0497
US

V. Phone/Fax

Practice location:
  • Phone: 501-941-1376
  • Fax: 501-941-2793
Mailing address:
  • Phone: 870-347-2534
  • Fax: 870-347-1235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number217468
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: