Individual
MICHAEL VINCEN-BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1115 12TH AVE, NAMPA, ID 83686
(208) 498-1080
(208) 498-1081
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 985-1399
(208) 985-6501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1538
ID
Other
Enumeration date
10/02/2017
Last updated
09/08/2021
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