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General NPI Number Information
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NPI Number | 1023974920
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Entity Type | Individual
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Provider Name | LEO JAY BROWN RN
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Gender | Male
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 544 N 3RD AVE
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City | ELDRIDGE
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State | IA
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Zip | 52748-1375
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Country | US
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Telephone | 630-207-9866
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Fax |
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Provider Business Mailing Address
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Address Line | 544 N 3RD AVE
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City | ELDRIDGE
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State | IA
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Zip | 52748-1375
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Country | US
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Telephone | 630-207-9866
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0100X
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Taxonomy Name | Gastroenterology Registered Nurse
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License Number | 041491591
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163WG0100X
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Taxonomy Name | Gastroenterology Registered Nurse
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License Number | 186510
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License Number State | IA
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