Healthcare Provider Details

I. General information

NPI: 1467689679
Provider Name (Legal Business Name): SUSAN GENEICE BROWN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2009
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 BURGESS ST
DELTA CO
81416-2849
US

IV. Provider business mailing address

PO BOX 10100
DELTA CO
81416-0008
US

V. Phone/Fax

Practice location:
  • Phone: 970-874-7668
  • Fax:
Mailing address:
  • Phone: 970-874-7668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71003991A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0991853-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: