Provider Demographics
NPI:1710905419
Name:BROWN, ELIZABETH BEATRICE (ARNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:BEATRICE
Last Name:BROWN
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:BEATRICE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1600 LAKELAND HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-3065
Mailing Address - Country:US
Mailing Address - Phone:863-680-7000
Mailing Address - Fax:866-264-8519
Practice Address - Street 1:1600 LAKELAND HILLS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-3019
Practice Address - Country:US
Practice Address - Phone:863-680-7300
Practice Address - Fax:866-264-8519
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2916592363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL303092000Medicaid
FLE4704UMedicare PIN
FLP22062Medicare UPIN
FL303092000Medicaid