Provider Demographics
NPI:1770803082
Name:BROWN, ERIKA NICOLE LEVIS (MD)
Entity type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:NICOLE LEVIS
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1700 W TOWNLINE ST
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801-1054
Mailing Address - Country:US
Mailing Address - Phone:641-782-7091
Mailing Address - Fax:641-782-3830
Practice Address - Street 1:1610 W TOWNLINE ST
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-1066
Practice Address - Country:US
Practice Address - Phone:641-782-2131
Practice Address - Fax:641-782-6425
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA39711207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP01288961OtherRR MEDICARE
IA1770803082Medicaid
IA1770803082Medicaid
IAP01288961OtherRR MEDICARE