Healthcare Provider Details

I. General information

NPI: 1558866806
Provider Name (Legal Business Name): MARY BROWN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 FARSON ST STE 112
BELPRE OH
45714-1000
US

IV. Provider business mailing address

416 COLEGATE DR BLDG 3
MARIETTA OH
45750-9549
US

V. Phone/Fax

Practice location:
  • Phone: 740-423-3202
  • Fax: 740-423-3212
Mailing address:
  • Phone: 740-374-3526
  • Fax: 740-374-3165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.022363
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN87708
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: