Provider Demographics
NPI:1619614989
Name:BROWN, TRICIA HAILEY (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:HAILEY
Last Name:BROWN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:TRICIA
Other - Middle Name:HAILEY
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6484 STATE ROUTE 546
Mailing Address - Street 2:
Mailing Address - City:BELLVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44813-9314
Mailing Address - Country:US
Mailing Address - Phone:419-989-8557
Mailing Address - Fax:
Practice Address - Street 1:661 S TRIMBLE RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-3437
Practice Address - Country:US
Practice Address - Phone:419-774-0478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031322363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner