Healthcare Provider Details

I. General information

NPI: 1447656921
Provider Name (Legal Business Name): FOLASHADE BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2014
Last Update Date: 05/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 PENNSYLVANIA AVE NW STE 8-416
WASHINGTON DC
20037
US

IV. Provider business mailing address

2212 AMBER MEADOWS DR
BOWIE MD
20716-1588
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-2227
  • Fax: 201-741-2637
Mailing address:
  • Phone: 301-218-5402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR125416
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: