Basic Information
Provider Information
NPI: 1477929479
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWN
FirstName: EMILY
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: FNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1800 W. CHARLESTON BLVD. STE. 508
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 89102
CountryCode: US
TelephoneNumber: 7023832688
FaxNumber: 7026716595
Practice Location
Address1: 1800 W. CHARLESTON BLVD.
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 89102
CountryCode: US
TelephoneNumber: 7023832000
FaxNumber: 7028709500
Other Information
ProviderEnumerationDate: 08/13/2015
LastUpdateDate: 09/21/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN64592NVN Nursing Service ProvidersRegistered Nurse 
363LF0000XAPRN002019NVY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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