Individual
COLEEN L BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
11420 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1729
(260) 484-8551
(260) 484-9603
Mailing address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5886
(260) 484-8551
(260) 484-9603
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28187556A
IN
367500000X
Certified Registered Nurse Anesthetist
4704101472
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200961560
—
IN
Enumeration date
06/30/2006
Last updated
11/07/2012
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