Healthcare Provider Details

I. General information

NPI: 1679434971
Provider Name (Legal Business Name): ALYSE BROWN APRN-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1590 WILLAMETTE ST
EUGENE OR
97401-4048
US

IV. Provider business mailing address

1590 WILLAMETTE ST
EUGENE OR
97401-4048
US

V. Phone/Fax

Practice location:
  • Phone: 541-357-7594
  • Fax:
Mailing address:
  • Phone: 541-357-7594
  • Fax: 503-343-6242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number10053261
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10053261
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number10053261
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: