Individual
CLOVIS JEAN BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2589 VZCR 1605, GRAND SALINE, TX 75140-5473
(903) 714-8283
Mailing address
2589 VZCR 1605, GRAND SALINE, TX 75140-5473
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
162725
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164X00000X
—
TX
Enumeration date
02/17/2018
Last updated
02/17/2018
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