Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 0024174345 | VA |
NPI | 1003360108 |
---|---|
Provider Name | Anissa Brown |
First Address | Arlington, VA 22203-1661 |
Second Address | Arlington, VA 22204-5703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2016 |
Last Update Date | 12/04/2017 |