Provider Demographics
NPI:1427016617
Name:BROWNELL, MARILYN DIANNE (NP)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:DIANNE
Last Name:BROWNELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1137 N CAREY AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-7371
Mailing Address - Country:US
Mailing Address - Phone:559-322-1092
Mailing Address - Fax:559-241-6448
Practice Address - Street 1:2615 E CLINTON AVE
Practice Address - Street 2:11G
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703-2223
Practice Address - Country:US
Practice Address - Phone:559-225-6100
Practice Address - Fax:559-241-6448
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA166863363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner