Healthcare Provider Details

I. General information

NPI: 1972811396
Provider Name (Legal Business Name): NATALIE CAROL BROWN MED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2010
Last Update Date: 09/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1556 N ARIZOLA RD
CASA GRANDE AZ
85122-5746
US

IV. Provider business mailing address

1556 N ARIZOLA RD
CASA GRANDE AZ
85122-0000
US

V. Phone/Fax

Practice location:
  • Phone: 520-876-9400
  • Fax:
Mailing address:
  • Phone: 520-876-9400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number4161716
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: