MEDICARE: MATRIKA J 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	71005108A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	834950003	OTHER	IN	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12752391	OTHER		CAQH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000000898948	OTHER		ANTHEM
4	71005108B	OTHER	IN	CRS

General Provider Information

NPI Number	:	1912300542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATRIKA J BROWN NP

Provider Business Mailing Address
First Line	:	7300 E INDIANA ST STE 103
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-7448
Country	:	US
Telephone Number	:	812-401-8008
Fax Number	:	812-401-8201

Provider Business Practice Location Address
First Line	:	7300 E INDIANA ST STE 103
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-7448
Country	:	US
Telephone Number	:	812-401-8008
Fax Number	:	812-401-8201

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

Provider Enumeration Date	:	09/26/2014
Last Update Date	:	03/07/2023

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Directions to “ MATRIKA J BROWN NP” Practice Location

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