Caleb Brown
Registered Nurse, Psych/Mental Health in Edwardsville, IL. Individual provider (NPI-1).
NPI number1063094530
StatusActive
Last updated in NPPESApr 24, 2021
Details
- NPI
- 1063094530
- Entity type
- Individual (NPI-1)
- Name
- Caleb Brown
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 24, 2021
- Certification date
- Apr 24, 2021
- Last updated
- Apr 24, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WP0808X | Registered Nurse, Psych/Mental Health | 041465387 | IL | Yes |
Practice location
912 N Main St Apt 10Edwardsville, IL 62025-1161
Phone 217-460-0033
Mailing address
912 N Main St Apt 10Edwardsville, IL 62025-1161
Phone 217-460-0033
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