Individual
ANGELA BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
302 FRESNO ST, SUITE 105, FRESNO, CA 93706-3600
(559) 478-5988
(559) 478-5335
Mailing address
792 E NEWCASTLE LN, FRESNO, CA 93720-0773
(559) 380-5733
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
23743
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0089960
—
CA
01
—
ZZZ02137Z
BLUE SHIELD
—
01
—
ZZZ20843Z
MEDICARE ID-TYPE UNSPECIFIED
—
Enumeration date
10/28/2013
Last updated
01/10/2016
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