Healthcare Provider Details

I. General information

NPI: 1043679541
Provider Name (Legal Business Name): LADONNA DELAINE BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2016
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 MEDICAL CENTER PKWY
AUGUSTA ME
04330
US

IV. Provider business mailing address

PO BOX 1541
DAVIDSON NC
28036-1541
US

V. Phone/Fax

Practice location:
  • Phone: 207-626-1000
  • Fax: 207-626-1000
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAC001920
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024176209
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: