Provider Demographics
NPI:1679082614
Name:BROWN, RONALD EARL II (PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:EARL
Last Name:BROWN
Suffix:II
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-7432
Mailing Address - Country:US
Mailing Address - Phone:985-790-2112
Mailing Address - Fax:
Practice Address - Street 1:500 RODERICK ST STE B
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-2278
Practice Address - Country:US
Practice Address - Phone:985-380-2460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09577363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health