Healthcare Provider Details

I. General information

NPI: 1902631195
Provider Name (Legal Business Name): AM'RA BROWN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1734 XIMENO AVE APT 14
LONG BEACH CA
90815-3752
US

IV. Provider business mailing address

1734 XIMENO AVE APT 14
LONG BEACH CA
90815-3752
US

V. Phone/Fax

Practice location:
  • Phone: 310-692-0645
  • Fax:
Mailing address:
  • Phone: 310-692-0645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number95110135
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95030070
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: