Provider Demographics
NPI:1003082983
Name:BROWN, ELAINE MICHELE (RN ARNP PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:MICHELE
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN ARNP PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 NE NEFF RD STE B
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6213
Mailing Address - Country:US
Mailing Address - Phone:541-647-2132
Mailing Address - Fax:541-728-0109
Practice Address - Street 1:2100 NE NEFF RD STE B
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6213
Practice Address - Country:US
Practice Address - Phone:541-647-2132
Practice Address - Fax:541-728-0109
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201150168NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health