Provider Demographics
NPI:1659485381
Name:BROWN, ERICA CHRISTINE (PT)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:CHRISTINE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:873 LEXINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-2729
Mailing Address - Country:US
Mailing Address - Phone:316-775-0700
Mailing Address - Fax:316-775-0730
Practice Address - Street 1:1503 WASHINGTON LN
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:KS
Practice Address - Zip Code:67010-1638
Practice Address - Country:US
Practice Address - Phone:316-775-0700
Practice Address - Fax:316-775-0730
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3555225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS140996OtherBLUE CROSS BLUE SHIELD
KS15090OtherPPK / EFFECTIVE: 1/1/2006
KS208516OtherHEALTH PARTNERS
KS208516OtherHEALTH PARTNERS