Individual
MITCHELL GARRETT BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
3101 E STATE ST, EAGLE, ID 83616-6232
(208) 473-3100
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
248862
AZ
363LF0000X
Family Nurse Practitioner
Primary
77052
ID
Other
Enumeration date
10/27/2020
Last updated
08/04/2023
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