MEDICARE: SUSAN BROWN APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	637	NV

General Provider Information

NPI Number	:	1144325325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN BROWN APN

Provider Business Mailing Address
First Line	:	PO BOX 34265
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-4265
Country	:	US
Telephone Number	:	702-255-0500
Fax Number	:	702-821-1704

Provider Business Practice Location Address
First Line	:	2901 N TENAYA WAY
Second Line	:	#210
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1404
Country	:	US
Telephone Number	:	702-255-0500
Fax Number	:	702-821-1704

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	05/29/2008

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Directions to “ SUSAN BROWN APN” Practice Location

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