Provider Demographics
NPI:1740416650
Name:BROWN, ALYSIA SHIRELL (APRN (NP-C))
Entity Type:Individual
Prefix:MRS
First Name:ALYSIA
Middle Name:SHIRELL
Last Name:BROWN
Suffix:
Gender:F
Credentials:APRN (NP-C)
Other - Prefix:MS
Other - First Name:ALYSIA
Other - Middle Name:SHIRELL
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN (NP-C)
Mailing Address - Street 1:1585 WOODLAKE DR
Mailing Address - Street 2:STE 104
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5740
Mailing Address - Country:US
Mailing Address - Phone:314-628-1307
Mailing Address - Fax:314-628-1609
Practice Address - Street 1:1585 WOODLAKE DR
Practice Address - Street 2:STE 104
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-5740
Practice Address - Country:US
Practice Address - Phone:314-628-1307
Practice Address - Fax:314-628-1309
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-05
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001010634363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily