Provider Demographics
NPI:1598308876
Name:BROUSE, ARTHUR EDWARD (APRN)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:EDWARD
Last Name:BROUSE
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 N NOVA RD STE 203
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-4422
Mailing Address - Country:US
Mailing Address - Phone:386-672-7175
Mailing Address - Fax:
Practice Address - Street 1:533 N NOVA RD STE 203
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-4422
Practice Address - Country:US
Practice Address - Phone:386-672-7175
Practice Address - Fax:386-972-0771
Is Sole Proprietor?:No
Enumeration Date:2019-10-19
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11004635363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health