Provider Demographics
NPI:1679186662
Name:BROWN, DANIEL HUNTER (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:HUNTER
Last Name:BROWN
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 ARKANSAS BLVD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:AR
Mailing Address - Zip Code:71854-2204
Mailing Address - Country:US
Mailing Address - Phone:870-774-7246
Mailing Address - Fax:
Practice Address - Street 1:1010 ARKANSAS BLVD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854-2204
Practice Address - Country:US
Practice Address - Phone:870-774-7246
Practice Address - Fax:870-774-7246
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1009206363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care