Healthcare Provider Details

I. General information

NPI: 1619778008
Provider Name (Legal Business Name): CIERRA BROWN LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. CIERRA WEYER

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 VETERANS DR
SAINT CLOUD MN
56303-2015
US

IV. Provider business mailing address

944 1ST ST S APT 9
SAUK RAPIDS MN
56379-1929
US

V. Phone/Fax

Practice location:
  • Phone: 320-255-6396
  • Fax:
Mailing address:
  • Phone: 320-293-6213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number823792
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: