Provider Demographics
NPI:1922788090
Name:BROWN, ELISA JEANNETTE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ELISA
Middle Name:JEANNETTE
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 1:8 FIELDCREST
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOPE
Mailing Address - State:KS
Mailing Address - Zip Code:67108-1014
Mailing Address - Country:US
Mailing Address - Phone:316-500-4821
Mailing Address - Fax:
Practice Address - Street 1:500 REFORMATORY ST
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501-3081
Practice Address - Country:US
Practice Address - Phone:620-662-2321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS82349363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care