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NPI Code Detail

MEDICARE: MRS. LAURIE L BROWN MPAS, PA-C

MEDICARE: MRS. LAURIE L BROWN MPAS, PA-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
1363A00000XPhysician Assistant207MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000097493OTHERMTBCBS

General Provider Information

NPI Number : 1790882652
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURIE L BROWN MPAS, PA-C
Provider Business Mailing Address
First Line : 3687 VETERANS DR
Second Line :
City : FORT HARRISON
State : MT
Zip : 59636-9703
Country : US
Telephone Number : 406-447-7505
Fax Number : 406-447-7235
Provider Business Practice Location Address
First Line : 3687 VETERANS DR
Second Line :
City : FORT HARRISON
State : MT
Zip : 59636-9703
Country : US
Telephone Number : 406-447-7505
Fax Number : 406-447-7235
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 11/04/2011

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