Provider Demographics
NPI:1144794827
Name:BRAWNER, ELIZABETH (APRN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BRAWNER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 BRIDGES AVE E STE A
Mailing Address - Street 2:
Mailing Address - City:WYNNE
Mailing Address - State:AR
Mailing Address - Zip Code:72396-2343
Mailing Address - Country:US
Mailing Address - Phone:870-208-8362
Mailing Address - Fax:870-208-8384
Practice Address - Street 1:750 BRIDGES AVE E STE A
Practice Address - Street 2:
Practice Address - City:WYNNE
Practice Address - State:AR
Practice Address - Zip Code:72396-2343
Practice Address - Country:US
Practice Address - Phone:870-208-8362
Practice Address - Fax:870-208-8384
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR225540363LF0000X
ARR099467163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily