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NPI Code Detail

MEDICARE: MRS. NYKEDTRA MARTIN BROWN FNP

MEDICARE: MRS. NYKEDTRA MARTIN BROWN FNP
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
1363LF0000XFamily Nurse Practitioner005001451NC

General Provider Information

NPI Number : 1811954969
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NYKEDTRA MARTIN BROWN FNP
Provider Business Mailing Address
First Line : 212 ASHTON GLN
Second Line :
City : DURHAM
State : NC
Zip : 27703-9451
Country : US
Telephone Number : 919-308-4027
Fax Number :
Provider Business Practice Location Address
First Line : 1002 S EUGENE ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27406-1308
Country : US
Telephone Number : 336-355-9696
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2006
Last Update Date : 09/06/2024

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