MEDICARE: ALLISON 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
1	363A00000X	Physician Assistant	63032	CA

General Provider Information

NPI Number	:	1881373785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON BROWN

Provider Business Mailing Address
First Line	:	20130 COUNTRY LAKE BLVD
Second Line	:
City	:	NOBLESVILLE
State	:	IN
Zip	:	46062-9327
Country	:	US
Telephone Number	:	317-506-2940
Fax Number	:

Provider Business Practice Location Address
First Line	:	1561 CREEKSIDE DR STE 140
Second Line	:
City	:	FOLSOM
State	:	CA
Zip	:	95630-3494
Country	:	US
Telephone Number	:	916-983-8595
Fax Number	:

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

Provider Enumeration Date	:	07/17/2023
Last Update Date	:	07/17/2023

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Directions to “ ALLISON BROWN ” Practice Location

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