Healthcare Provider Details

I. General information

NPI: 1497039234
Provider Name (Legal Business Name): LEANORA LOUISE BROWN C.N.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2011
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 HESTERS CROSSING RD SUITE 101
ROUND ROCK TX
78681-8027
US

IV. Provider business mailing address

970 HESTERS CROSSING RD SUITE 101
ROUND ROCK TX
78681-8027
US

V. Phone/Fax

Practice location:
  • Phone: 512-238-0762
  • Fax: 512-341-7370
Mailing address:
  • Phone: 512-238-0762
  • Fax: 512-341-7370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberPENDING
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: