Provider Demographics
NPI:1144299249
Name:BROWN, MARTHA ELIZABETH (ARNP)
Entity type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:ELIZABETH
Last Name:BROWN
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:PO BOX 44008
Mailing Address - Street 2:UFJP PROVIDER ENROLLMENT
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4008
Mailing Address - Country:US
Mailing Address - Phone:904-244-3199
Mailing Address - Fax:904-244-3425
Practice Address - Street 1:800 PRUDENTIAL DR
Practice Address - Street 2:UFJP PEDIATRIC CRITICAL CARE MEDICINE
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8202
Practice Address - Country:US
Practice Address - Phone:904-202-8758
Practice Address - Fax:904-306-9884
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2012-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP2551402363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA188838750BMedicaid
FLQ49268Medicare UPIN
GA188838750BMedicaid
FLU5399ZMedicare PIN