Healthcare Provider Details

I. General information

NPI: 1124780929
Provider Name (Legal Business Name): ALEXANDRIA BROWN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2021
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3963 ROUTE 37
MARION IL
62959-6546
US

IV. Provider business mailing address

3963 ROUTE 37
MARION IL
62959-6546
US

V. Phone/Fax

Practice location:
  • Phone: 618-422-4989
  • Fax:
Mailing address:
  • Phone: 618-422-4989
  • Fax: 943-770-8563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277.003371
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number277.003371
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: