Provider Demographics
NPI:1821430216
Name:BROWN, ALICE MAE (CNP)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:MAE
Last Name:BROWN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:EL CENTRO FAMILY HEALTH
Mailing Address - City:ESPANOLA
Mailing Address - State:NM
Mailing Address - Zip Code:87532-0158
Mailing Address - Country:US
Mailing Address - Phone:505-753-7218
Mailing Address - Fax:505-753-5815
Practice Address - Street 1:1235 8TH ST
Practice Address - Street 2:EL CENTRO FAMILY HEALTH LAS VEGAS CLINIC
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-4219
Practice Address - Country:US
Practice Address - Phone:505-425-6788
Practice Address - Fax:505-425-5408
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMCNP-02224363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily