Healthcare Provider Details

I. General information

NPI: 1477795557
Provider Name (Legal Business Name): REGINA A. BROWN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2009
Last Update Date: 04/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 STONEHEDGE DR
HENDERSON NC
27537-7222
US

IV. Provider business mailing address

29 STONEHEDGE DR
HENDERSON NC
27537-7222
US

V. Phone/Fax

Practice location:
  • Phone: 252-438-4663
  • Fax: 252-438-4663
Mailing address:
  • Phone: 252-438-4663
  • Fax: 252-438-4663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number179121
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: