Healthcare Provider Details

I. General information

NPI: 1285079152
Provider Name (Legal Business Name): COROLINE LOUISE BROWN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2013
Last Update Date: 05/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 DORCHESTER RD
CHARLESTON SC
29418-5101
US

IV. Provider business mailing address

6401 DORCHESTER RD
CHARLESTON SC
29418-5101
US

V. Phone/Fax

Practice location:
  • Phone: 843-207-3019
  • Fax: 843-207-3084
Mailing address:
  • Phone: 843-207-3019
  • Fax: 843-207-3084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number19354
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: