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General NPI Number Information
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NPI Number | 1578780508
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Entity Type | Individual
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Provider Name | STACEY DEESE BROWN ARNP
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 11/20/2008
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Provider Practice Location Address
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Address Line | 11030 RCA CENTER DR SUITE 3015
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4276
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Country | US
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Telephone | 561-776-7041
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Fax |
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Provider Business Mailing Address
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Address Line | 371 MAGNOLIA DR
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City | JUPITER
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State | FL
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Zip | 33458-8379
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Country | US
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Telephone | 561-575-1769
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3279132
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License Number State | FL
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