Provider Demographics
NPI:1689863136
Name:BROWN, SUSAN P (NP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:P
Last Name:BROWN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10219 CROSSCUT WAY
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:MD
Mailing Address - Zip Code:20872-2909
Mailing Address - Country:US
Mailing Address - Phone:612-767-1919
Mailing Address - Fax:
Practice Address - Street 1:8901 ROCKVILLE PIKE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-1136
Practice Address - Country:US
Practice Address - Phone:301-295-6400
Practice Address - Fax:301-319-2172
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR093463363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD082NS139Medicare PIN
DC002905M72Medicare UPIN