Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | SP014236 | PA |
NPI | 1053794545 |
---|---|
Provider Name | Dr. Dana Brown |
First Address | Philadelphia, PA 19104-4551 |
Second Address | Philadelphia, PA 19104-4551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2015 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RN594539 | RN (01) | PA |
SP014236 | NCC WHNC-BC (01) | PA |
SP014925 | CRNP (01) | PA |