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General NPI Number Information
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NPI Number | 1265022206
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Entity Type | Individual
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Provider Name | SHAWN BROWN APRN
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Gender | Female
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Dates
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Enumeration Date | 01/23/2021
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Last Update Date | 10/05/2025
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Provider Practice Location Address
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Address Line | 3461 SW ENGLEWOOD ST
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City | PORT ST LUCIE
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State | FL
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Zip | 34953-4940
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Country | US
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Telephone | 772-708-8279
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Fax |
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Provider Business Mailing Address
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Address Line | 3461 SW ENGLEWOOD ST
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City | PORT ST LUCIE
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State | FL
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Zip | 34953-4940
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Country | US
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Telephone | 772-708-8279
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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 | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 11040959
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 11040959
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 11040959
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9453562
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License Number State | FL
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