Healthcare Provider Details

I. General information

NPI: 1144877978
Provider Name (Legal Business Name): HARRY BROWN JR. APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 CIVIC CENTER BLVD
HOUMA LA
70360-5937
US

IV. Provider business mailing address

5153 PINHOOK PLACE
HOUMA LA
70360
US

V. Phone/Fax

Practice location:
  • Phone: 985-333-2020
  • Fax:
Mailing address:
  • Phone: 985-665-9560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP207819
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: