Provider Demographics
NPI:1225364227
Name:BROWN, NICHOLE THERESA (DNP, PMHNP-C, FNP-C)
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:THERESA
Last Name:BROWN
Suffix:
Gender:F
Credentials:DNP, PMHNP-C, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32531 N SCOTTSDALE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85266-1519
Mailing Address - Country:US
Mailing Address - Phone:602-837-3324
Mailing Address - Fax:
Practice Address - Street 1:20325 N 51ST AVE STE 160
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-4622
Practice Address - Country:US
Practice Address - Phone:623-466-6350
Practice Address - Fax:602-358-8698
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-26
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3477363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health