Healthcare Provider Details

I. General information

NPI: 1104064583
Provider Name (Legal Business Name): YASMIN KIMBERLY BROWN O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2009
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 BRENTWOOD RD NE SUITE B-3
WASHINGTON DC
20018-1052
US

IV. Provider business mailing address

1060 BRENTWOOD RD NE SUITE B-3
WASHINGTON DC
20018-1052
US

V. Phone/Fax

Practice location:
  • Phone: 202-269-5252
  • Fax:
Mailing address:
  • Phone: 202-269-5252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618001818
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOP1000182
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: