Provider Demographics
NPI:1144568650
Name:BROWN, REBECCA JOY (PNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JOY
Last Name:BROWN
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 VILLAGE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-5387
Mailing Address - Country:US
Mailing Address - Phone:864-327-9003
Mailing Address - Fax:800-253-0649
Practice Address - Street 1:316 VILLAGE CREEK DR
Practice Address - Street 2:
Practice Address - City:BOILING SPRINGS
Practice Address - State:SC
Practice Address - Zip Code:29316-5387
Practice Address - Country:US
Practice Address - Phone:864-327-9003
Practice Address - Fax:800-253-0649
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-18
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC0263363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics