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Individual

IAN JASON BROWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
12 WESTBROOK CMN, WESTBROOK, ME 04092-2819
(207) 856-1500
(207) 856-1518
Mailing address
78 ATLANTIC PLACE, SOUTH PORTLAND, ME 04106-2316
(207) 661-6654
(207) 842-7773

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN57149
ME
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP111011
ME

Other

Enumeration date
04/01/2011
Last updated
04/20/2015
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