Provider Demographics
NPI:1114243623
Name:BROWN, MARTHA J (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:J
Last Name:BROWN
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6320 GATEWAY BLVD E
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2006
Mailing Address - Country:US
Mailing Address - Phone:915-772-2111
Mailing Address - Fax:
Practice Address - Street 1:6320 GATEWAY BLVD E
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2006
Practice Address - Country:US
Practice Address - Phone:915-772-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-09
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP118885363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX212760701Medicaid
NM59185546Medicaid
TX212760702Medicaid
NM59185546Medicaid