Provider Demographics
NPI:1346784808
Name:BROWN, ASHLEY GRACE (ARNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:GRACE
Last Name:BROWN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 INGERSOLL AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-5201
Mailing Address - Country:US
Mailing Address - Phone:402-350-2634
Mailing Address - Fax:
Practice Address - Street 1:2105 INGERSOLL AVE STE 101
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-5201
Practice Address - Country:US
Practice Address - Phone:402-350-2634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-16
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA156721363LF0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program