Healthcare Provider Details

I. General information

NPI: 1447319868
Provider Name (Legal Business Name): MARSHA A BROWN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 08/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10001 S EASTERN AVE SUITE 309
HENDERSON NV
89052-3907
US

IV. Provider business mailing address

9971 LIBERTY VIEW RD
LAS VEGAS NV
89148-5509
US

V. Phone/Fax

Practice location:
  • Phone: 702-269-6345
  • Fax:
Mailing address:
  • Phone: 702-622-1173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number679771
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPN000939
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: