Individual
MS. LANA MARIE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, NREMT
Contact information
Practice address
912 14TH STREET NORTH, VIRGINIA, MN 55792
(320) 226-7480
Mailing address
912 14TH STREET NORTH, VIRGINIA, MN 55792
(320) 226-7480
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
020302074
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020302074
NATABOC NUMBER
MN
01
—
1728
MN STATE REGISTRATION
MN
Enumeration date
11/16/2006
Last updated
05/17/2016
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