Provider Demographics
NPI:1093048076
Name:BROWN, SHELLEY ANN
Entity Type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 41TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23369
Mailing Address - Country:US
Mailing Address - Phone:757-604-6598
Mailing Address - Fax:757-604-6898
Practice Address - Street 1:634 44TH STREET
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VA
Practice Address - Zip Code:23607
Practice Address - Country:US
Practice Address - Phone:757-604-6598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA14010261633747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant