Provider Demographics
NPI:1811536568
Name:BROWN, CAROLYN (FNP-C)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:BETH
Other - Last Name:TIEVY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:14075 PATTERSON FARM CT
Mailing Address - Street 2:
Mailing Address - City:GLENELG
Mailing Address - State:MD
Mailing Address - Zip Code:21737-9768
Mailing Address - Country:US
Mailing Address - Phone:303-818-0395
Mailing Address - Fax:
Practice Address - Street 1:919 UNIVERSITY BLVD W
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1055
Practice Address - Country:US
Practice Address - Phone:240-740-6952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-29
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR137611207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine