Healthcare Provider Details

I. General information

NPI: 1023298056
Provider Name (Legal Business Name): SUSAN N BROWN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2007
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 INDIANA AVE
LUBBOCK TX
79415-3364
US

IV. Provider business mailing address

309 N SLIDE RD
LUBBOCK TX
79416-1549
US

V. Phone/Fax

Practice location:
  • Phone: 806-775-9700
  • Fax:
Mailing address:
  • Phone: 806-775-9700
  • Fax: 806-472-6802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1096406
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF05260232
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: