Provider Demographics
NPI:1255101960
Name:AMY BROWN NP, LLC
Entity type:Organization
Organization Name:AMY BROWN NP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FNP-C
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:N
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:207-713-4649
Mailing Address - Street 1:30 ROOSEVELT ST APT 1
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-2043
Mailing Address - Country:US
Mailing Address - Phone:207-713-4649
Mailing Address - Fax:
Practice Address - Street 1:27 OCEAN ST STE 3
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2854
Practice Address - Country:US
Practice Address - Phone:207-713-4649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty