Individual
MRS. SAMANTHA JO BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
26136 US HIGHWAY 59, FAIRFAX, MO 64446-8155
(660) 686-2211
(660) 686-2618
Mailing address
26136 US HIGHWAY 59, FAIRFAX, MO 64446-9635
(660) 686-2211
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2004002504
MO
363LF0000X
Family Nurse Practitioner
A111977
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCBS
00594011
MO
Enumeration date
04/12/2007
Last updated
09/30/2019
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