Provider Demographics
NPI:1184165250
Name:BROWN, TERRY (CFCS)
Entity type:Individual
Prefix:MRS
First Name:TERRY
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:CFCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8716 N FIVE FORKS RD
Mailing Address - Street 2:
Mailing Address - City:AMELIA COURT HOUSE
Mailing Address - State:VA
Mailing Address - Zip Code:23002-4846
Mailing Address - Country:US
Mailing Address - Phone:804-839-3655
Mailing Address - Fax:866-402-8325
Practice Address - Street 1:8716 N FIVE FORKS RD
Practice Address - Street 2:
Practice Address - City:AMELIA COURT HOUSE
Practice Address - State:VA
Practice Address - Zip Code:23002-4846
Practice Address - Country:US
Practice Address - Phone:804-839-3655
Practice Address - Fax:866-402-8325
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001184864163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse