Provider Demographics
NPI:1033190830
Name:BROWN, ESTHER EUGENIA (FNP)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:EUGENIA
Last Name:BROWN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 LANCASTER DR NE STE 108
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-1065
Mailing Address - Country:US
Mailing Address - Phone:971-273-0679
Mailing Address - Fax:503-961-0794
Practice Address - Street 1:1880 LANCASTER DR NE STE 108
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1065
Practice Address - Country:US
Practice Address - Phone:971-273-0679
Practice Address - Fax:503-961-0794
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200250080NP363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR080234Medicaid
OR080234Medicaid
OR1228590003Medicare NSC
ORR158954Medicare PIN