Provider Demographics
NPI:1942701024
Name:BROWN, ALLYSON L (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:L
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 MANNING BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-7637
Mailing Address - Country:US
Mailing Address - Phone:757-617-9230
Mailing Address - Fax:
Practice Address - Street 1:751 MANNING BRIDGE RD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-7637
Practice Address - Country:US
Practice Address - Phone:757-617-9230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001202814163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant