Provider Demographics
NPI:1144650672
Name:BROWN, ELISECIA (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ELISECIA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 LAPALCO BLVD
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-7302
Mailing Address - Country:US
Mailing Address - Phone:504-371-9355
Mailing Address - Fax:
Practice Address - Street 1:605 LAPALCO BLVD
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-7302
Practice Address - Country:US
Practice Address - Phone:504-371-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07470363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily