Healthcare Provider Details

I. General information

NPI: 1417652819
Provider Name (Legal Business Name): LAUREL BROWNING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 LEE ST
CHARLOTTESVILLE VA
22908-0816
US

IV. Provider business mailing address

1215 LEE ST
CHARLOTTESVILLE VA
22908-0816
US

V. Phone/Fax

Practice location:
  • Phone: 434-924-5321
  • Fax: 434-244-4142
Mailing address:
  • Phone: 434-924-5321
  • Fax: 434-244-4142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0102210201
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: