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NPI Code Detail

MEDICARE: LAQUANDRA BROWN

MEDICARE:   LAQUANDRA  BROWN
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
1363L00000XNurse Practitioner24500SC

General Provider Information

NPI Number : 1558031377
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAQUANDRA BROWN
Provider Business Mailing Address
First Line : 4900 OHEAR AVE STE 100
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29405-5091
Country : US
Telephone Number : 843-410-5386
Fax Number : 843-323-4689
Provider Business Practice Location Address
First Line : 4900 OHEAR AVE STE 100
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29405-5091
Country : US
Telephone Number : 843-410-5386
Fax Number : 843-323-4689
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2021
Last Update Date : 03/24/2026

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Directions to “ LAQUANDRA BROWN ” Practice Location

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