Provider Demographics
NPI:1508839655
Name:BROWN, LAURA E (PA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:BROWN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 S. PARK ST.
Mailing Address - Street 2:MERITER HEALTH SERVICES
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-1507
Mailing Address - Country:US
Mailing Address - Phone:608-417-3817
Mailing Address - Fax:
Practice Address - Street 1:2601 W BELTLINE HWY
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-2316
Practice Address - Country:US
Practice Address - Phone:608-417-2100
Practice Address - Fax:608-417-2101
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1722-023246XC2903X
WI1722-23363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular Specialist