Provider Demographics
NPI:1013163286
Name:BROWN, CONSTANCE (MD)
Entity Type:Individual
Prefix:DR
First Name:CONSTANCE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3675 PECOS MCLEOD STE 700
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-3811
Mailing Address - Country:US
Mailing Address - Phone:702-606-8737
Mailing Address - Fax:702-485-5212
Practice Address - Street 1:3675 PECOS MCLEOD STE 700
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3811
Practice Address - Country:US
Practice Address - Phone:702-606-8737
Practice Address - Fax:702-485-5212
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10965207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty