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NPI Code Detail

MEDICARE: PATRICIA FITZGERALD BROWN

MEDICARE: PATRICIA FITZGERALD BROWN
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
1364SP0808XPsychiatric/Mental Health Clinical Nurse SpecialistCNS0366MN

General Provider Information

NPI Number : 1568741502
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA FITZGERALD BROWN
Provider Business Mailing Address
First Line : 1900 SILVER LAKE RD NW
Second Line : SUITE 110
City : NEW BRIGHTON
State : MN
Zip : 55112-1786
Country : US
Telephone Number : 651-628-9566
Fax Number :
Provider Business Practice Location Address
First Line : 13603 80TH CIR N
Second Line :
City : MAPLE GROVE
State : MN
Zip : 55369-8961
Country : US
Telephone Number : 763-746-9492
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2011
Last Update Date : 02/27/2017

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Directions to “ PATRICIA FITZGERALD BROWN ” Practice Location

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