Healthcare Provider Details

I. General information

NPI: 1902342785
Provider Name (Legal Business Name): NATALIE ANN BROWN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2017
Last Update Date: 02/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 E OCEAN AVE
LOMPOC CA
93436-7092
US

IV. Provider business mailing address

555 1/2 S RESH ST
ANAHEIM CA
92805-4442
US

V. Phone/Fax

Practice location:
  • Phone: 805-737-3300
  • Fax:
Mailing address:
  • Phone: 949-878-6458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number95000646
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: