Healthcare Provider Details

I. General information

NPI: 1134890262
Provider Name (Legal Business Name): ALLISON BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2021
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1473 N FRANKLIN AVE
LOUISVILLE CO
80027-1651
US

IV. Provider business mailing address

1473 N FRANKLIN AVE
LOUISVILLE CO
80027-1651
US

V. Phone/Fax

Practice location:
  • Phone: 207-249-5004
  • Fax:
Mailing address:
  • Phone: 207-249-5004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN.1626721
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: