Provider Demographics
NPI:1295041796
Name:BROWN, CARMEN LYNETTE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:LYNETTE
Last Name:BROWN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:CARMEN
Other - Middle Name:LYNETTE
Other - Last Name:SOLOMON-BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:806 JEFFERSON TER
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-5727
Mailing Address - Country:US
Mailing Address - Phone:337-365-4945
Mailing Address - Fax:
Practice Address - Street 1:806 JEFFERSON TER
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-5727
Practice Address - Country:US
Practice Address - Phone:337-365-4945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAF0810065363LF0000X
LAAPRN06264363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2122886Medicaid
LA3C149CQ60Medicare PIN