Provider Demographics
NPI:1790083194
Name:BROWN, CHRISTINE PAULA (PNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:PAULA
Last Name:BROWN
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6395 HUGHES GLEN CT
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-1211
Mailing Address - Country:US
Mailing Address - Phone:513-777-1975
Mailing Address - Fax:
Practice Address - Street 1:5900 BOYMEL DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-5526
Practice Address - Country:US
Practice Address - Phone:513-874-9460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 05914363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics