Provider Demographics
NPI:1689380289
Name:BROWN, MADISON ELISA
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:ELISA
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 WALKER BLDG
Mailing Address - Street 2:
Mailing Address - City:AUBURN UNIVERSITY
Mailing Address - State:AL
Mailing Address - Zip Code:36849-0001
Mailing Address - Country:US
Mailing Address - Phone:334-844-8348
Mailing Address - Fax:
Practice Address - Street 1:2316 WALKER BLDG
Practice Address - Street 2:
Practice Address - City:AUBURN UNIVERSITY
Practice Address - State:AL
Practice Address - Zip Code:36849-0001
Practice Address - Country:US
Practice Address - Phone:334-844-8348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program