Susan Kay Brown, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Laramie, WY
NPI 1104461599 · NPPES record last updated Jan 13, 2020
Key facts
- NPI
- 1104461599
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 44909 (WY)
- Practice address
- 121 E Grand Ave Ste 204
Laramie, WY 82070-3600 - Phone
- (307) 316-4410
- NPI assigned
- Nov 9, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44909 | WY | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 44909 | WY | Yes |
Addresses
Primary practice location
121 E Grand Ave Ste 204
Laramie, WY 82070-3600
Mailing address
121 E Grand Ave Ste 204
Laramie, WY 82070-3600
Phone (307) 316-4410
Other providers in Laramie, WY
- Kamille Brough
- Elizabeth A Brown
- Emma Brown
- Mackenzie Brown
- Meghan Rose Brown
- Tanya Brown
- Jacob Brownell
- David Bruch
- Holly Bruch
- Dave R Brumbaugh
All providers in Laramie, WY · Psychiatric/Mental Health Nurse Practitioner in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.