1538581756 NPI number — COLLEEN E BROWN ARNP, RN

Table of content: COLLEEN E BROWN ARNP, RN (NPI 1538581756)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538581756 NPI number — COLLEEN E BROWN ARNP, RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
COLLEEN
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP, RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
AVERY
Provider Other First Name:
COLLEEN
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARNP, RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538581756
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/04/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1865 ROUTE 70 EAST
Provider Second Line Business Mailing Address:
STE 210
Provider Business Mailing Address City Name:
CHERRY HILL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08003-2013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-795-0587
Provider Business Mailing Address Fax Number:
856-795-0689

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1865 ROUTE 70 EAST
Provider Second Line Business Practice Location Address:
STE 210
Provider Business Practice Location Address City Name:
CHERRY HILL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08003-2013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-795-0587
Provider Business Practice Location Address Fax Number:
856-795-0689
Provider Enumeration Date:
01/07/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LW0102X , with the licence number:  26NJ01142800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1538581756 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com