Healthcare Provider Details

I. General information

NPI: 1467624205
Provider Name (Legal Business Name): SHELLEY MARIE BROWN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2008
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 N 4TH ST
WILMINGTON NC
28401-3450
US

IV. Provider business mailing address

925 N 4TH ST
WILMINGTON NC
28401-3450
US

V. Phone/Fax

Practice location:
  • Phone: 910-343-0270
  • Fax:
Mailing address:
  • Phone: 910-343-0270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP09920
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: