Provider Demographics
NPI:1649395450
Name:BROWN, DENISE GLENETTE (CRNA)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:GLENETTE
Last Name:BROWN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3780 SE 55TH CT.
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-9339
Mailing Address - Country:US
Mailing Address - Phone:353-694-6962
Mailing Address - Fax:
Practice Address - Street 1:3780 SE 55TH CT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-9339
Practice Address - Country:US
Practice Address - Phone:352-694-6962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2752222367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered