Provider Demographics
NPI:1447430616
Name:BROWN, ANGELA D (APN)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:D
Last Name:BROWN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:D
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:427 W NORTHMOOR RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-3542
Mailing Address - Country:US
Mailing Address - Phone:309-692-5337
Mailing Address - Fax:309-693-3913
Practice Address - Street 1:427 W NORTHMOOR RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-3542
Practice Address - Country:US
Practice Address - Phone:309-692-5337
Practice Address - Fax:309-693-3913
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209006808363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care