Healthcare Provider Details

I. General information

NPI: 1700651817
Provider Name (Legal Business Name): HEATHER BROWN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2023
Last Update Date: 11/20/2023
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W MINERAL KING AVE
VISALIA CA
93291-6237
US

IV. Provider business mailing address

1445 S HILLCREST DR
VISALIA CA
93292-5155
US

V. Phone/Fax

Practice location:
  • Phone: 559-624-2000
  • Fax:
Mailing address:
  • Phone: 559-300-7541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number95118362
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: