Provider Demographics
NPI:1720762586
Name:BROWN, TRINIA LASONIA (FNP)
Entity Type:Individual
Prefix:
First Name:TRINIA
Middle Name:LASONIA
Last Name:BROWN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2442 SOUTHMONT DR APT 302
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-7090
Mailing Address - Country:US
Mailing Address - Phone:336-782-4280
Mailing Address - Fax:
Practice Address - Street 1:115 WHITE RD
Practice Address - Street 2:
Practice Address - City:KING
Practice Address - State:NC
Practice Address - Zip Code:27021-9526
Practice Address - Country:US
Practice Address - Phone:336-983-6505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5018170207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine