Healthcare Provider Details

I. General information

NPI: 1942399134
Provider Name (Legal Business Name): CARA E. BROWN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARA E. PHILLIPS

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 03/18/2020
Certification Date: 03/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

473 CASTLE PINES AVE STE 1
JOHNSTOWN CO
80534-7859
US

IV. Provider business mailing address

6801 W 20TH ST SUITE 101, ATTN: SUSAN PINCKNEY
GREELEY CO
80634-9637
US

V. Phone/Fax

Practice location:
  • Phone: 970-587-7881
  • Fax: 970-587-7738
Mailing address:
  • Phone: 970-378-8000
  • Fax: 970-378-8088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number46036
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2004028828
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: