Provider Demographics
NPI:1225011992
Name:BROWER, DEBORAH R (CRNP)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:R
Last Name:BROWER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:489 MAIN ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-3187
Mailing Address - Country:US
Mailing Address - Phone:410-414-5633
Mailing Address - Fax:410-414-5911
Practice Address - Street 1:489 MAIN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3187
Practice Address - Country:US
Practice Address - Phone:410-414-5633
Practice Address - Fax:410-414-5911
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-27
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR126934363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD000215100Medicaid
MD512809900Medicaid
P59831Medicare UPIN
MDP59831Medicare UPIN