MEDICARE: PAIGE ALYSON BROWN FNP-C

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	163W00000X	Registered Nurse	28196830A	IN
2	363LF0000X	Family Nurse Practitioner	71015004A	IN

General Provider Information

NPI Number	:	1558005629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAIGE ALYSON BROWN FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 775383
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-5383
Country	:	US
Telephone Number	:	812-376-5315
Fax Number	:

Provider Business Practice Location Address
First Line	:	4001 W GOELLER BLVD
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-8308
Country	:	US
Telephone Number	:	812-375-3330
Fax Number	:

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

Provider Enumeration Date	:	04/25/2022
Last Update Date	:	01/06/2025

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