Provider Demographics
NPI:1598143653
Name:BROWN, ALETHIA
Entity Type:Individual
Prefix:
First Name:ALETHIA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 W COLD SPRING LN
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-2802
Mailing Address - Country:US
Mailing Address - Phone:443-524-6600
Mailing Address - Fax:443-524-6608
Practice Address - Street 1:220 W COLD SPRING LN
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2802
Practice Address - Country:US
Practice Address - Phone:443-524-6600
Practice Address - Fax:443-524-6608
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-09
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR166040363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily