=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770827503
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARTHA ELIZABETH BROWN FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/16/2012
-----------------------------------------------------
Last Update Date | 07/08/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25 DEPOT ST
-----------------------------------------------------
City | KINGFIELD
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04947-4208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-265-4555
-----------------------------------------------------
Fax | 207-264-5004
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25 DEPOT ST
-----------------------------------------------------
City | KINGFIELD
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04947-4208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-265-4555
-----------------------------------------------------
Fax | 207-264-5004
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | CNP171018
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | ARNP1514222
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 4704305289
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 1461
-----------------------------------------------------
License Number State | AK
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | CNP-02420
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | AP8534
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------