Healthcare Provider Details

I. General information

NPI: 1588714570
Provider Name (Legal Business Name): SHAMEKA TEANEA BROWN DNP, FNP-BC, CME
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 05/05/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 N BRIDGE ST
ELKTON MD
21921-5326
US

IV. Provider business mailing address

437 CROYDEN RD
UPPER DARBY PA
19082-5105
US

V. Phone/Fax

Practice location:
  • Phone: 410-392-6408
  • Fax: 410-392-6409
Mailing address:
  • Phone: 267-679-3579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLG-0001062
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAC002225
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN628620
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTE00718
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: