Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 0024171885 | VA |
NPI | 1184032187 |
---|---|
Provider Name | Charlene Mary Brown |
First Address | Aldie, VA 20105-5653 |
Second Address | Winchester, VA 22601-2808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2014 |
Last Update Date | 30/07/2014 |