Healthcare Provider Details

I. General information

NPI: 1891139416
Provider Name (Legal Business Name): CHRISTINA NICOLE BROWN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2013
Last Update Date: 05/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 REAGAN ST
DALLAS TX
75219-3225
US

IV. Provider business mailing address

2345 REAGAN ST
DALLAS TX
75219-3225
US

V. Phone/Fax

Practice location:
  • Phone: 214-999-1044
  • Fax: 214-296-4704
Mailing address:
  • Phone: 214-999-1044
  • Fax: 214-296-4704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number778145
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number778145
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License Number778145
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number778145
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: