Healthcare Provider Details

I. General information

NPI: 1548940166
Provider Name (Legal Business Name): GAIL POWERS BROWNING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 COUGAR LN
STUART VA
24171-4519
US

IV. Provider business mailing address

215 COUGAR LN
STUART VA
24171-4519
US

V. Phone/Fax

Practice location:
  • Phone: 276-694-3137
  • Fax:
Mailing address:
  • Phone: 276-694-3137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number0126000342
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: