Healthcare Provider Details

I. General information

NPI: 1972540995
Provider Name (Legal Business Name): VIRGINIA ANNE BROWN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 09/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 PERRYRIDGE RD
GREENWICH CT
06830-4608
US

IV. Provider business mailing address

5 PERRYRIDGE RD
GREENWICH CT
06830-4608
US

V. Phone/Fax

Practice location:
  • Phone: 203-661-5330
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number000939
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR36893
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: