Provider Demographics
NPI:1154619344
Name:BROWN, REBECCA ELIZABETH (NP)
Entity type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:ELIZABETH
Last Name:BROWN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:PO BOX 402669
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-2669
Mailing Address - Country:US
Mailing Address - Phone:512-206-4300
Mailing Address - Fax:512-206-4350
Practice Address - Street 1:3801 N LAMAR BLVD
Practice Address - Street 2:STE. 300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-4080
Practice Address - Country:US
Practice Address - Phone:512-206-3600
Practice Address - Fax:512-421-3830
Is Sole Proprietor?:No
Enumeration Date:2011-07-21
Last Update Date:2011-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX641690363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB137572Medicare PIN
TXTXB134446Medicare PIN