MEDICARE: DR. CHARLES BROWN JR. APRN FNP-BC DHA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	RN1009112	DC

General Provider Information

NPI Number	:	1255479804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES BROWN JR. APRN FNP-BC DHA

Provider Business Mailing Address
First Line	:	1012 14TH ST NW APT 221
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20005-3403
Country	:	US
Telephone Number	:	202-638-0750
Fax Number	:

Provider Business Practice Location Address
First Line	:	3636 GEORGIA AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20010-1646
Country	:	US
Telephone Number	:	202-446-1100
Fax Number	:	202-204-0806

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	04/27/2022

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