Provider Demographics
NPI:1992232839
Name:BROWN, COLLIN STEVEN (MSN, CRNA)
Entity type:Individual
Prefix:
First Name:COLLIN
Middle Name:STEVEN
Last Name:BROWN
Suffix:
Gender:M
Credentials:MSN, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5796 BOSFORD ST SW
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:OH
Mailing Address - Zip Code:44662-9727
Mailing Address - Country:US
Mailing Address - Phone:281-881-3003
Mailing Address - Fax:
Practice Address - Street 1:500 GYPSY LANE
Practice Address - Street 2:ANESTHESIA DEPT
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44501
Practice Address - Country:US
Practice Address - Phone:281-881-3003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-22
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH334162367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered