Provider Demographics
NPI:1396098059
Name:BROWN, MARLENE ANGELA (PMHNP-BC, APRN-CNP)
Entity type:Individual
Prefix:
First Name:MARLENE
Middle Name:ANGELA
Last Name:BROWN
Suffix:
Gender:F
Credentials:PMHNP-BC, APRN-CNP
Other - Prefix:
Other - First Name:M.
Other - Middle Name:ANGELA
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP-BC, APRN-CNP
Mailing Address - Street 1:1327 N. SUNSET LANE
Mailing Address - Street 2:
Mailing Address - City:GUYMON
Mailing Address - State:OK
Mailing Address - Zip Code:73942-3141
Mailing Address - Country:US
Mailing Address - Phone:501-613-7863
Mailing Address - Fax:580-297-9105
Practice Address - Street 1:212 NW 5TH ST
Practice Address - Street 2:
Practice Address - City:GUYMON
Practice Address - State:OK
Practice Address - Zip Code:73942-4204
Practice Address - Country:US
Practice Address - Phone:501-613-7863
Practice Address - Fax:580-297-9105
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK89143163W00000X
OK216007363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse