Healthcare Provider Details

I. General information

NPI: 1013132307
Provider Name (Legal Business Name): MICHELLE JACQUELINE BROWN BSC, BED, OD, FAAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE JACQUELINE HOUDE

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 GRAND AVE
BILLINGS MT
59102-3027
US

IV. Provider business mailing address

PO BOX 80686
BILLINGS MT
59108-0686
US

V. Phone/Fax

Practice location:
  • Phone: 406-245-2010
  • Fax:
Mailing address:
  • Phone: 406-245-2010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number733
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: