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General NPI Number Information
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NPI Number | 1801570577
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Entity Type | Individual
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Provider Name | LEANDRA NICOLE BROWN PA
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Gender | Female
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Dates
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Enumeration Date | 06/13/2023
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 1310 14TH AVE SE
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City | DECATUR
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State | AL
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Zip | 35601-4347
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Country | US
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Telephone | 256-705-4224
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Fax | 256-705-4135
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Provider Business Mailing Address
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Address Line | PO BOX 18428
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City | HUNTSVILLE
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State | AL
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Zip | 35804-8428
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Country | US
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Telephone | 256-705-4224
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Fax | 256-705-4135
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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 | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | 167672
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number | 167672
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.2289
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License Number State | AL
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