Healthcare Provider Details

I. General information

NPI: 1265210868
Provider Name (Legal Business Name): LAURA ANNE BROWN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2023
Last Update Date: 02/29/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 SW ARCHER RD
GAINESVILLE FL
32608-1134
US

IV. Provider business mailing address

PO BOX 100236
GAINESVILLE FL
32610-0236
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-8408
  • Fax: 352-733-9348
Mailing address:
  • Phone: 352-273-5550
  • Fax: 352-273-5575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11028442
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: