Healthcare Provider Details

I. General information

NPI: 1326872938
Provider Name (Legal Business Name): BAILEE ELISABETH BROWN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2024
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W 7TH ST
FREDERICK MD
21701-4506
US

IV. Provider business mailing address

1120 WILCOX CT
FREDERICK MD
21702-6837
US

V. Phone/Fax

Practice location:
  • Phone: 240-566-3300
  • Fax:
Mailing address:
  • Phone: 240-397-3635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: