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General NPI Number Information
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NPI Number | 1578878740
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Entity Type | Individual
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Provider Name | NICOLE ELIZABETH BROWN PA
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Gender | Female
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Dates
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Enumeration Date | 08/12/2010
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 1101 SAM PERRY BLVD STE 314
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-4466
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Country | US
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Telephone | 540-374-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 705 QUAIL CREEK DR
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City | AMARILLO
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State | TX
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Zip | 79124-1608
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110010578
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 002420
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA13285
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 002420
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License Number State | CT
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