Basic Information
| Provider Information | |||||||||
| NPI: | 1326039173 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4001 WABASH AVE | ||||||||
| Address2: | |||||||||
| City: | TERRE HAUTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 478031647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122387711 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4001 WABASH AVE | ||||||||
| Address2: | |||||||||
| City: | TERRE HAUTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 478031647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122387711 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 01029415A | IN | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.