Provider Demographics
NPI:1245854702
Name:BROWN, ERYNN MICHELLE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ERYNN
Middle Name:MICHELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ERYNN
Other - Middle Name:MICHELLE
Other - Last Name:STIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2106 GABRIEL DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-2506
Mailing Address - Country:US
Mailing Address - Phone:231-408-7666
Mailing Address - Fax:
Practice Address - Street 1:1000 HARRINGTON ST
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-2920
Practice Address - Country:US
Practice Address - Phone:231-408-7666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601009998363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant