| Provider / Organization | NPI | Date Certified |
|---|---|---|
| LATERRA BROWN | 1417608985 | 2022-01-15 |
Laterra Brown is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1417608985. Registration indicates Laterra Brown is a provider of access to mental health/behavioral health providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Psych/Mental Health, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Psych/Mental Health, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| Entity Type | Individual |
| Provider Name | Laterra Brown PMHNP-BC |
| Practice Office Address | 1701 WHITE STREET MCCOMB, MS US |
| Practice Office Telephone | 6016842173 |
| Practice Office Fax | 6012491062 |
| Mailing Address | 1701 WHITE STREET MCCOMB, MS 396482711 US |
| Business Telephone | 6012494235 |
| Business Fax | 6012494234 |
| Direct Messaging Address [] | [email protected] |
| Code | Practice | License No State |
|---|---|---|
| 363LP0808X PRIMARY | Access to Mental Health/Behavioral Health Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Psych/Mental Health All Other Specialties & Provider Types Nurse Practitioner Psych/Mental Health Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 905000
MS |
| 03722090 | MEDICAID | MS | |
| 2021028561 | OTHER | MS | PMHNP CERTIFICA |