Healthcare Provider Details

I. General information

NPI: 1114853124
Provider Name (Legal Business Name): VICTORIA ANN BROWN PPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 JASMINE ST
CASPER WY
82604-4039
US

IV. Provider business mailing address

26 JASMINE ST
CASPER WY
82604-4039
US

V. Phone/Fax

Practice location:
  • Phone: 307-254-8260
  • Fax:
Mailing address:
  • Phone: 307-254-8260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPPC-1655
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: