Provider Demographics
NPI:1003401498
Name:BROWN, CARA R (APRN)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:R
Last Name:BROWN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:R
Other - Last Name:HANKS AND MAGEDANZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:405 SW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:ALEDO
Mailing Address - State:IL
Mailing Address - Zip Code:61231-1707
Mailing Address - Country:US
Mailing Address - Phone:309-219-1664
Mailing Address - Fax:
Practice Address - Street 1:1100 36TH AVE
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-7127
Practice Address - Country:US
Practice Address - Phone:309-743-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209022935363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily