Bernice Brown, RN

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

License

28201235A Issued in IN

Practice address

2121 Lake Ave
Fort Wayne, IN 46805-5100

Phone

(260) 426-5431

Fax

(260) 421-1035

NPI assigned

Jun 7, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1659000651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055100",
            "telephone_number": "260-426-5431",
            "fax_number": "260-421-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055100",
            "telephone_number": "260-426-5431",
            "fax_number": "260-421-1035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "BERNICE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "IN",
            "license": "28201235A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA NORTHERN INDIANA HEALTH CARE SYSTEM",
            "identifier": "28201235A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28201235A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Scott Brown, DO
• Ashley K. Brown
• Ashley Kamea Lynn Brown, NP-C
• Bailey Brown, MS, BCBA
• Bailie Brown
• Burton D K Brown, DDS MSD PC
• Carissa L Brown
• Chelsie Brown, MA, LMHC
• Christy R. Brown, CRNA
• Chynal Brown

• Medical-Surgical Registered Nurse in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Medical-Surgical Registered Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.