Angela M Brown, FNP-BC
Individual provider Active NPI Nurse Practitioner · Lake Orion, MI
NPI 1457099566 · NPPES record last updated Apr 24, 2023
Key facts
- NPI
- 1457099566
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 4704361557 (MI)
- Practice address
- 454 Fay CT
Lake Orion, MI 48362-1846 - Phone
- (248) 842-2662
- NPI assigned
- May 27, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230414000868 | MI | Practitioner - Nurse Practitioner | 6305211863 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704361557 | MI | MD | Psychiatric/Mental Health Nurse Practitioner |
| 4704361557NSA220DR | MI | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vpa PC | Current |
Accepting new patients | |
| Experience This Home Care L.L.C. | Current |
Accepting new patients | |
| Vpa PC | Current |
Accepting new patients | |
| Vpa PC | Current | Accepting new patients |
Locations
500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704361557 | MI | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 4704361557 | MI | |
| Primary Care Nurse Practitioner | 363LP2300X | 4704361557NSA220DR | MI | |
| Nurse Practitioner | 363L00000X | 4704361557 | MI | Yes |
Addresses
Primary practice location
454 Fay CT
Lake Orion, MI 48362-1846
Mailing address
454 Fay CT
Lake Orion, MI 48362-1846
Phone (248) 842-2662
Other providers in Lake Orion, MI
- Loren Mark Brett
- Brightstone Occupational Therapy Consultants, LLC
- Evan Brikho
- Christine Anne Brooks
- Sacoya Tara Brooks
- Mairead Brown
- Alesha Brunk
- Sydney Jean Bryce
- Rebecca Burger
- Emily Morgan Burrows
All providers in Lake Orion, MI · Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.