Healthcare Provider Details

I. General information

NPI: 1467366674
Provider Name (Legal Business Name): CHANDLER MARIE BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 WALKER AVENUE NURSING & INSTRUCTIONAL BUILDING
GREENSBORO NC
27412-5019
US

IV. Provider business mailing address

113 TERRILYNN WAY
ELIZABETH CITY NC
27909-7719
US

V. Phone/Fax

Practice location:
  • Phone: 252-267-6172
  • Fax:
Mailing address:
  • Phone: 252-267-6172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number372577
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: