Basic Information
| Provider Information | |||||||||
| NPI: | 1932121001 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | MERLE | ||||||||
| MiddleName: | |||||||||
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| Credential: | ARNP, PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8340 NW 25TH ST | ||||||||
| Address2: | |||||||||
| City: | SUNRISE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333222934 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545723848 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2011 NW 3RD AVE | ||||||||
| Address2: | |||||||||
| City: | POMPANO BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330604800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547865941 | ||||||||
| FaxNumber: | 9547860129 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2006 | ||||||||
| LastUpdateDate: | 09/03/2008 | ||||||||
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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 | 363LA2100X | 9236493 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
ID Information
| ID | Type | State | Issuer | Description | 9236493 | 01 | FL | ARNP | OTHER | MB0826341 | 01 | FL | DEA | OTHER |