Provider Demographics
NPI:1700836111
Name:BROWN, ASADRA SUE (PMH/NP)
Entity Type:Individual
Prefix:MS
First Name:ASADRA
Middle Name:SUE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PMH/NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 HOYLES ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:OLD FORT
Mailing Address - State:NC
Mailing Address - Zip Code:28762-5600
Mailing Address - Country:US
Mailing Address - Phone:828-668-9478
Mailing Address - Fax:828-668-9478
Practice Address - Street 1:732 HOYLES ORCHARD RD
Practice Address - Street 2:
Practice Address - City:OLD FORT
Practice Address - State:NC
Practice Address - Zip Code:28762-5600
Practice Address - Country:US
Practice Address - Phone:828-668-9478
Practice Address - Fax:828-668-9478
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201352363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12767OtherBLUE CROSS BLUE SHIELD
NCP00006471OtherMEDICARE RAILROAD
SCQNP016OtherSOUTH CAROLINA MEDICAID
NC6113019Medicaid
NCMB0617704OtherDEA NUMBER
NC12767OtherBLUE CROSS BLUE SHIELD
NCP00006471OtherMEDICARE RAILROAD