Provider Demographics
NPI:1306380936
Name:BROWN, BERNADETTE CELESTIAL (AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:CELESTIAL
Last Name:BROWN
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 MEDICAL PLAZA DR STE 170
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3477
Mailing Address - Country:US
Mailing Address - Phone:281-444-1303
Mailing Address - Fax:281-444-5161
Practice Address - Street 1:1111 MEDICAL PLAZA DR STE 170
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3477
Practice Address - Country:US
Practice Address - Phone:281-444-1303
Practice Address - Fax:281-444-5161
Is Sole Proprietor?:No
Enumeration Date:2016-12-16
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130774363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner