Provider Demographics
NPI:1851761381
Name:BROWN, EMILY ELISABETH (MPAS, PA-C)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:ELISABETH
Last Name:BROWN
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:ELISABETH
Other - Last Name:WATKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPAS, PA-C
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-2584
Mailing Address - Country:US
Mailing Address - Phone:513-705-4754
Mailing Address - Fax:513-420-5156
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45005-2584
Practice Address - Country:US
Practice Address - Phone:513-705-4754
Practice Address - Fax:513-420-5156
Is Sole Proprietor?:No
Enumeration Date:2015-09-26
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52852363A00000X
OH50.004933RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant