Provider Demographics
NPI:1538581756
Name:BROWN, COLLEEN E (ARNP, RN)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:E
Last Name:BROWN
Suffix:
Gender:F
Credentials:ARNP, RN
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:ELIZABETH
Other - Last Name:AVERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP, RN
Mailing Address - Street 1:1865 ROUTE 70 EAST
Mailing Address - Street 2:STE 210
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2013
Mailing Address - Country:US
Mailing Address - Phone:856-795-0587
Mailing Address - Fax:856-795-0689
Practice Address - Street 1:1865 ROUTE 70 EAST
Practice Address - Street 2:STE 210
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2013
Practice Address - Country:US
Practice Address - Phone:856-795-0587
Practice Address - Fax:856-795-0689
Is Sole Proprietor?:No
Enumeration Date:2014-01-07
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01142800363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1538581756Medicaid
WA1538581756Medicaid