Provider Demographics
NPI:1043348550
Name:BARNDS BROWN, JOSEPHINE MARIA (PA)
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:MARIA
Last Name:BARNDS BROWN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DAVOL SQ
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4754
Mailing Address - Country:US
Mailing Address - Phone:401-421-4000
Mailing Address - Fax:401-272-1456
Practice Address - Street 1:78 BAKER ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-4417
Practice Address - Country:US
Practice Address - Phone:401-781-2400
Practice Address - Fax:401-781-2687
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA00099363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIJB86765Medicaid
RI302704OtherBLUE CROSS PIN NO
RIJB86765Medicaid