Provider Demographics
NPI:1013387414
Name:BROWN, STACY LEIGH (RN, BSN)
Entity Type:Individual
Prefix:MS
First Name:STACY
Middle Name:LEIGH
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11000 BUDDY ELLIS RD APT 522
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-6165
Mailing Address - Country:US
Mailing Address - Phone:225-202-1399
Mailing Address - Fax:
Practice Address - Street 1:353 N 12TH ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-4612
Practice Address - Country:US
Practice Address - Phone:225-242-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA83106163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health