Provider Demographics
NPI:1477896256
Name:BROWN, SUSAN (LPN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4782 DIVIDING RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-1335
Mailing Address - Country:US
Mailing Address - Phone:410-713-4957
Mailing Address - Fax:410-943-0667
Practice Address - Street 1:3680 WARWICK RD
Practice Address - Street 2:
Practice Address - City:EAST NEW MARKET
Practice Address - State:MD
Practice Address - Zip Code:21631-1420
Practice Address - Country:US
Practice Address - Phone:410-943-8108
Practice Address - Fax:410-943-0667
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP49534164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse