Provider Demographics
NPI:1366185209
Name:BROWN-CHITOU, LATRICE (CNP)
Entity type:Individual
Prefix:
First Name:LATRICE
Middle Name:
Last Name:BROWN-CHITOU
Suffix:
Gender:
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4241 JOHNNY CAKE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-2235
Mailing Address - Country:US
Mailing Address - Phone:651-688-7041
Mailing Address - Fax:
Practice Address - Street 1:4241 JOHNNY CAKE RIDGE RD
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-2235
Practice Address - Country:US
Practice Address - Phone:732-451-4318
Practice Address - Fax:888-974-0983
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9092363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily