Healthcare Provider Details

I. General information

NPI: 1871012997
Provider Name (Legal Business Name): LAUREN A BROWN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2017
Last Update Date: 12/22/2021
Certification Date: 12/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E THORPE ST
LAKIN KS
67860-9625
US

IV. Provider business mailing address

506 E THORPE ST
LAKIN KS
67860-9625
US

V. Phone/Fax

Practice location:
  • Phone: 620-355-7501
  • Fax:
Mailing address:
  • Phone: 620-355-7550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number43-557522
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1053768
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: