Provider Demographics
NPI:1437226818
Name:BROWNE, GERARD (LAC)
Entity Type:Individual
Prefix:MR
First Name:GERARD
Middle Name:
Last Name:BROWNE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8598 PINEHURST ALCOVE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-9177
Mailing Address - Country:US
Mailing Address - Phone:651-264-0234
Mailing Address - Fax:
Practice Address - Street 1:5770 W BALD EAGLE BLVD
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-6440
Practice Address - Country:US
Practice Address - Phone:651-429-9595
Practice Address - Fax:651-429-9595
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1133171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP35767OtherHP ID NUMBER