MEDICARE: MARILYN MAXFIELD BROWN R.N.

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	163WS0200X	School Registered Nurse	RN029462	AZ

General Provider Information

NPI Number	:	1275664286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARILYN MAXFIELD BROWN R.N.

Provider Business Mailing Address
First Line	:	1025 N COUNTRY CLUB DR
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85201-3307
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1630 E SOUTHERN AVE
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85204-5220
Country	:	US
Telephone Number	:	480-472-5916
Fax Number	:

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

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	07/08/2007

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