Provider Demographics
NPI:1639675960
Name:BROWN-GIX, BROOKE PERSHUNNA (RN)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:PERSHUNNA
Last Name:BROWN-GIX
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 KENTUCKY ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-3957
Mailing Address - Country:US
Mailing Address - Phone:318-680-6395
Mailing Address - Fax:
Practice Address - Street 1:1691 BIENVILLE DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3756
Practice Address - Country:US
Practice Address - Phone:318-343-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN128458163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LARN128458OtherRN LICENSURE