Provider Demographics
NPI:1639341167
Name:BROWN, ANDREW C (APN)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:C
Last Name:BROWN
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 KUENZLI ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-0845
Mailing Address - Country:US
Mailing Address - Phone:775-982-4590
Mailing Address - Fax:775-982-5496
Practice Address - Street 1:1495 MILL ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1479
Practice Address - Country:US
Practice Address - Phone:775-982-3500
Practice Address - Fax:775-982-3663
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001037363L00000X
NVRN41949163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
11934096OtherCAQH
NVV105685Medicare PIN