Basic Information
| Provider Information | |||||||||
| NPI: | 1154773729 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | TASHINA | ||||||||
| MiddleName: | DIANNA | ||||||||
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| Credential: | DNP, PMHNP/FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 90 TWEEDY TRL | ||||||||
| Address2: | |||||||||
| City: | POCAHONTAS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724551269 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8706310496 | ||||||||
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| Practice Location | |||||||||
| Address1: | 503 SE LINDSEY ST | ||||||||
| Address2: | |||||||||
| City: | HOXIE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724332224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8708861333 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2016 | ||||||||
| LastUpdateDate: | 07/07/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | A00487 | AR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.