Provider Demographics
NPI:1144700196
Name:BROWN, LISA ANNE (RN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 W 15TH ST STE 1025
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7253
Mailing Address - Country:US
Mailing Address - Phone:214-207-8664
Mailing Address - Fax:
Practice Address - Street 1:1860 COUNTY ROAD 217
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:TX
Practice Address - Zip Code:76424-8749
Practice Address - Country:US
Practice Address - Phone:214-207-8664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX581118163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse