Provider Demographics
NPI:1619663382
Name:BROWN PSYCHIATRY PLLC
Entity Type:Organization
Organization Name:BROWN PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MISS
Authorized Official - First Name:MISPA
Authorized Official - Middle Name:
Authorized Official - Last Name:NKONGHO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:214-900-2529
Mailing Address - Street 1:3101 N CENTRAL AVE STE 183
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-3616
Mailing Address - Country:US
Mailing Address - Phone:084-827-1730
Mailing Address - Fax:
Practice Address - Street 1:822 N VINE AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-9175
Practice Address - Country:US
Practice Address - Phone:214-900-2529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty