Provider Demographics
NPI:1528102373
Name:BROWN, LAURANNE ELISA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LAURANNE
Middle Name:ELISA
Last Name:BROWN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18101 ANTIETAM CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-1710
Mailing Address - Country:US
Mailing Address - Phone:813-458-2418
Mailing Address - Fax:
Practice Address - Street 1:18101 ANTIETAM CT # 7
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-1710
Practice Address - Country:US
Practice Address - Phone:813-458-2418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11037767363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL767451100Medicaid