Provider Demographics
NPI:1346753415
Name:BROWN, DANNEL SCOTT (FNP-BC)
Entity Type:Individual
Prefix:
First Name:DANNEL
Middle Name:SCOTT
Last Name:BROWN
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-0432
Mailing Address - Country:US
Mailing Address - Phone:606-218-6402
Mailing Address - Fax:606-218-7502
Practice Address - Street 1:911 BYPASS RD # CLINIC2
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1689
Practice Address - Country:US
Practice Address - Phone:606-218-6402
Practice Address - Fax:606-218-7502
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704257840363LF0000X
KY3011910363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily