Provider Demographics
NPI:1306361936
Name:BROWN, NINA (ATC)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6817 SANCTUARY CT
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6297
Mailing Address - Country:US
Mailing Address - Phone:443-909-8595
Mailing Address - Fax:
Practice Address - Street 1:6817 SANCTUARY CT
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6297
Practice Address - Country:US
Practice Address - Phone:443-909-8595
Practice Address - Fax:443-909-8595
Is Sole Proprietor?:No
Enumeration Date:2017-08-04
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer