Provider Demographics
NPI:1538452081
Name:BROWN, VENUS RAE (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:VENUS
Middle Name:RAE
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4759
Mailing Address - Country:US
Mailing Address - Phone:406-457-8918
Mailing Address - Fax:
Practice Address - Street 1:1930 9TH AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4759
Practice Address - Country:US
Practice Address - Phone:406-457-8918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT27780163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant