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NPI Code Detail

MEDICARE: LINDA JEAN FULLER-BROWN MD

MEDICARE:   LINDA JEAN FULLER-BROWN  MD
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
12084P0800XPsychiatry PhysicianC50966CA

General Provider Information

NPI Number : 1760543276
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA JEAN FULLER-BROWN MD
Provider Business Mailing Address
First Line : 7436 CHIPPING SPARROW ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89084-4808
Country : US
Telephone Number : 702-217-9904
Fax Number :
Provider Business Practice Location Address
First Line : 7436 CHIPPING SPARROW ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89084-4808
Country : US
Telephone Number : 702-217-9904
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2006
Last Update Date : 05/10/2016

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Directions to “ LINDA JEAN FULLER-BROWN MD” Practice Location

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