Provider Demographics
NPI:1891238408
Name:BROWN, KEESHA MACHIE (APRN)
Entity Type:Individual
Prefix:MS
First Name:KEESHA
Middle Name:MACHIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6125 HIGHWAY 161 S
Mailing Address - Street 2:
Mailing Address - City:SCOTT
Mailing Address - State:AR
Mailing Address - Zip Code:72142-9351
Mailing Address - Country:US
Mailing Address - Phone:501-952-1568
Mailing Address - Fax:
Practice Address - Street 1:6125 HIGHWAY 161 S
Practice Address - Street 2:
Practice Address - City:SCOTT
Practice Address - State:AR
Practice Address - Zip Code:72142-9351
Practice Address - Country:US
Practice Address - Phone:501-952-1568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004900363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care