Healthcare Provider Details

I. General information

NPI: 1205657541
Provider Name (Legal Business Name): ESIE BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2024
Last Update Date: 10/19/2024
Certification Date: 10/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9026 JEFFERSON HWY STE 200
BATON ROUGE LA
70809-2433
US

IV. Provider business mailing address

9026 JEFFERSON HWY STE 200
BATON ROUGE LA
70809-2433
US

V. Phone/Fax

Practice location:
  • Phone: 225-334-7800
  • Fax:
Mailing address:
  • Phone: 225-334-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberU88S06WTZX
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: