Provider Demographics
NPI:1548596976
Name:BROWN, MONICA (CNP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ARROW SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-7002
Mailing Address - Country:US
Mailing Address - Phone:513-282-7911
Mailing Address - Fax:
Practice Address - Street 1:100 ARROW SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-7002
Practice Address - Country:US
Practice Address - Phone:513-282-7911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH04612363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3015696Medicaid
OH3015696Medicaid