Provider Demographics
NPI:1447297445
Name:BROWN, LOIS V (FNP)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:V
Last Name:BROWN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3634 IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-4901
Mailing Address - Country:US
Mailing Address - Phone:901-363-2107
Mailing Address - Fax:901-363-2165
Practice Address - Street 1:3634 IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-4901
Practice Address - Country:US
Practice Address - Phone:901-363-2107
Practice Address - Fax:901-363-2165
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN31993163W00000X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3902876Medicaid
TN3902876Medicaid
TN3902876Medicare ID - Type UnspecifiedCIGNA MEDICARE