Provider Demographics
NPI:1245298728
Name:BROWN, PAMELA ANN (CRNP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 OLD WESTMINSTER PIKE STE 202
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-6276
Mailing Address - Country:US
Mailing Address - Phone:410-848-0364
Mailing Address - Fax:410-848-4037
Practice Address - Street 1:531 OLD WESTMINSTER PIKE STE 202
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6276
Practice Address - Country:US
Practice Address - Phone:410-848-0364
Practice Address - Fax:410-848-4037
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR069634363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD407241300Medicaid
MD407241300Medicaid
DCU15Medicare PIN
MD1245298728OtherNPI
MDQ42974Medicare UPIN
MDO695Medicare PIN