Provider Demographics
NPI:1750695375
Name:BROWN, REBECCA ELAINE (APRN, NP-C)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ELAINE
Last Name:BROWN
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ELAINE
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0853
Mailing Address - Country:US
Mailing Address - Phone:972-715-5000
Mailing Address - Fax:972-715-9976
Practice Address - Street 1:13600 ADDISON RD
Practice Address - Street 2:SUITE 300
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001
Practice Address - Country:US
Practice Address - Phone:972-920-6968
Practice Address - Fax:975-885-2975
Is Sole Proprietor?:No
Enumeration Date:2010-08-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP119229363L00000X, 363LF0000X
TX717199363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2853525-01Medicaid
TXTXB134747Medicare PIN