Healthcare Provider Details

I. General information

NPI: 1790762078
Provider Name (Legal Business Name): ALYCIA BROWN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 12/27/2023
Certification Date: 12/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 NC HWY 105
BOONE NC
28607-2860
US

IV. Provider business mailing address

PO BOX 1987
BOONE NC
28607-1987
US

V. Phone/Fax

Practice location:
  • Phone: 828-202-9765
  • Fax: 877-847-0561
Mailing address:
  • Phone: 828-202-9765
  • Fax: 828-579-2764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number200101428
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number200101428
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: