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General NPI Number Information
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NPI Number | 1912003583
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Entity Type | Individual
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Provider Name | RODICA CARMEN BROWN PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 10409 MANZANILLO AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-1724
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Country | US
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Telephone | 505-304-4248
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Fax | 505-544-2620
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Provider Business Mailing Address
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Address Line | 10409 MANZANILLO AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-1724
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Country | US
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Telephone | 505-299-2634
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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 | PA2002-0030
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License Number State | NM
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