Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 0116022791 | VA |
Y | 207Q00000X | Family Doctor | 2018-02329 | NC |
N | 207Q00000X | Family Doctor | 35.122200 | OH |
NPI | 1003127218 |
---|---|
Provider Name | Regina Braxton Bray Brown |
First Address | Chillicothe, OH 45601-1186 |
Second Address | Coats, NC 27521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2010 |
Last Update Date | 25/10/2018 |