Provider Demographics
NPI:1366850208
Name:BROWNE, ERIN M (PA)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:M
Last Name:BROWNE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:M
Other - Last Name:GALLAGHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:324 GREYBULL DR
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-2174
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:121 BECKS WOODS DR STE 100
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-3853
Practice Address - Country:US
Practice Address - Phone:866-862-2955
Practice Address - Fax:302-836-4302
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0005433363AM0700X
DEC5-0001197363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1366850208Medicaid