Provider Demographics
NPI:1023240041
Name:BROWN, HEIDI LEE (FNP-BC, APRN)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:LEE
Last Name:BROWN
Suffix:
Gender:F
Credentials:FNP-BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11415 560TH ST
Mailing Address - Street 2:
Mailing Address - City:RUSH CITY
Mailing Address - State:MN
Mailing Address - Zip Code:55069-9438
Mailing Address - Country:US
Mailing Address - Phone:320-980-3067
Mailing Address - Fax:
Practice Address - Street 1:7650 CURRELL BLVD STE 330
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-8209
Practice Address - Country:US
Practice Address - Phone:651-738-7800
Practice Address - Fax:651-738-9501
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6648-33363LF0000X
MNCNP 3849363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily