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General NPI Number Information
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NPI Number | 1932179843
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Entity Type | Individual
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Provider Name | MARY MARGARET BROWN FNP
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Gender | Female
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 06/11/2018
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Provider Practice Location Address
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Address Line | 3600 RIVERS AVE
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City | NORTH CHARLESTON
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State | SC
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Zip | 29405
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Country | US
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Telephone | 843-574-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 185 AZALEA CT
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City | O FALLON
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State | IL
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Zip | 62269-7038
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Country | US
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Telephone | 618-726-7712
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 472041
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209009217
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License Number State | IL
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