Provider Demographics
NPI:1679587299
Name:BROWN, JANET ELAINE (FNPC, RNFA)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:ELAINE
Last Name:BROWN
Suffix:
Gender:F
Credentials:FNPC, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3314 DORADO PL
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-7706
Mailing Address - Country:US
Mailing Address - Phone:760-942-9074
Mailing Address - Fax:
Practice Address - Street 1:3350 LA JOLLA VILLAGE DR
Practice Address - Street 2:MC- 112A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161-0002
Practice Address - Country:US
Practice Address - Phone:858-642-3093
Practice Address - Fax:858-552-4376
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 404382363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA364SF0001XMedicaid
CA364SF0001XOtherFAMILY NURSE PRACTITIONER
CA364SF0001XMedicare ID - Type UnspecifiedFAMILY NURSE PRACTITIONER
CA364SF0001XOtherFAMILY NURSE PRACTITIONER