Provider Demographics
NPI:1740873173
Name:BROWN, MADELINE (FNP)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6695 W BOYNTON BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3527
Mailing Address - Country:US
Mailing Address - Phone:740-438-1851
Mailing Address - Fax:
Practice Address - Street 1:2655 S STATE ROAD 7 # E830
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-9377
Practice Address - Country:US
Practice Address - Phone:561-501-0203
Practice Address - Fax:561-437-8400
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-17
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF01211368363LF0000X
FLAPRN11014755363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily