Healthcare Provider Details

I. General information

NPI: 1245216449
Provider Name (Legal Business Name): PENNY L. BROWN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 CATHERINE CREEK RD S
AHOSKIE NC
27910-3905
US

IV. Provider business mailing address

703 CATHERINE CREEK RD S
AHOSKIE NC
27910-3905
US

V. Phone/Fax

Practice location:
  • Phone: 252-209-0088
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201964
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number201964
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: