Healthcare Provider Details

I. General information

NPI: 1568296507
Provider Name (Legal Business Name): LADONNA SEBRINA BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2024
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2474 WALNUT ST # 137
CARY NC
27518-9212
US

IV. Provider business mailing address

2474 WALNUT ST # 137
CARY NC
27518-9212
US

V. Phone/Fax

Practice location:
  • Phone: 919-523-2868
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2024094026
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number347920
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: