Provider Demographics
NPI:1740934462
Name:BROWN, COURTNEY (MS)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 PINE AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3183
Mailing Address - Country:US
Mailing Address - Phone:405-819-5520
Mailing Address - Fax:
Practice Address - Street 1:1141 PINE AVE APT 10
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3183
Practice Address - Country:US
Practice Address - Phone:405-819-5520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program