Provider Demographics
NPI:1043507601
Name:BROWN, ANDREA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 STAFFORD MARKET PL
Mailing Address - Street 2:T-1857
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-4523
Mailing Address - Country:US
Mailing Address - Phone:540-658-9927
Mailing Address - Fax:540-658-9927
Practice Address - Street 1:1090 STAFFORD MARKET PL
Practice Address - Street 2:T-1857
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-4523
Practice Address - Country:US
Practice Address - Phone:540-658-9927
Practice Address - Fax:540-658-9927
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202209374183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist