Provider Demographics
NPI:1952870172
Name:BROWN, ANGELA CHRISTINE (BSN)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:CHRISTINE
Last Name:BROWN
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:S1100 SOBKOWIAK LN
Mailing Address - Street 2:
Mailing Address - City:STODDARD
Mailing Address - State:WI
Mailing Address - Zip Code:54658-9753
Mailing Address - Country:US
Mailing Address - Phone:608-317-5408
Mailing Address - Fax:
Practice Address - Street 1:S1100 SOBKOWIAK LN
Practice Address - Street 2:
Practice Address - City:STODDARD
Practice Address - State:WI
Practice Address - Zip Code:54658-9753
Practice Address - Country:US
Practice Address - Phone:608-317-5408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI137093163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI137093OtherRN