MEDICARE: AM'RA BROWN NP

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	163WC0200X	Critical Care Medicine Registered Nurse	95110135	CA
2	363LF0000X	Family Nurse Practitioner	95030070	CA

General Provider Information

NPI Number	:	1902631195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AM'RA BROWN NP

Provider Business Mailing Address
First Line	:	1734 XIMENO AVE APT 14
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-3752
Country	:	US
Telephone Number	:	310-692-0645
Fax Number	:

Provider Business Practice Location Address
First Line	:	1734 XIMENO AVE APT 14
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-3752
Country	:	US
Telephone Number	:	310-692-0645
Fax Number	:

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

Provider Enumeration Date	:	09/05/2024
Last Update Date	:	09/05/2024

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