Provider Demographics
NPI:1326686361
Name:BROWN, ANDREA SHIRLEY (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:SHIRLEY
Last Name:BROWN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3046 TRANQUIL CAROL CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-0566
Mailing Address - Country:US
Mailing Address - Phone:775-229-3449
Mailing Address - Fax:
Practice Address - Street 1:3201 S MARYLAND PKWY STE 608
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2428
Practice Address - Country:US
Practice Address - Phone:702-457-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-19
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA2207363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical