Healthcare Provider Details

I. General information

NPI: 1891876900
Provider Name (Legal Business Name): PAULA M BROWN DNP, APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2609 GLENN HENDREN DR
LIBERTY MO
64068-3313
US

IV. Provider business mailing address

2609 GLENN HENDREN DR
LIBERTY MO
64068-3313
US

V. Phone/Fax

Practice location:
  • Phone: 816-407-4555
  • Fax: 816-781-6973
Mailing address:
  • Phone: 816-407-4555
  • Fax: 816-781-6973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number110740
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: