Provider Demographics
NPI:1902410111
Name:BROWN, ALICIA PHALON (NP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:PHALON
Last Name:BROWN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3090 MCBRIDE CT STE B
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-0812
Mailing Address - Country:US
Mailing Address - Phone:513-863-8212
Mailing Address - Fax:
Practice Address - Street 1:3090 MCBRIDE CT STE B
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-0812
Practice Address - Country:US
Practice Address - Phone:513-863-8212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0027486363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology