Provider Demographics
NPI:1104066695
Name:BROWN, LORENE K (RN,MS, ACNS-BC)
Entity type:Individual
Prefix:
First Name:LORENE
Middle Name:K
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN,MS, ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CHOCTAW CIR
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-9505
Mailing Address - Country:US
Mailing Address - Phone:952-934-4861
Mailing Address - Fax:
Practice Address - Street 1:120 CHOCTAW CIR
Practice Address - Street 2:
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-9505
Practice Address - Country:US
Practice Address - Phone:612-242-1878
Practice Address - Fax:952-934-4861
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN033951305364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health