Provider Demographics
NPI:1770361396
Name:OAKLEY BROWN CORP
Entity type:Organization
Organization Name:OAKLEY BROWN CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:EZIZNWA
Authorized Official - Last Name:NWOGWUGWU
Authorized Official - Suffix:
Authorized Official - Credentials:DRPH, MSN, MPH, APRN
Authorized Official - Phone:443-743-7184
Mailing Address - Street 1:575 S CHARLES ST STE 140
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-2477
Mailing Address - Country:US
Mailing Address - Phone:443-743-7184
Mailing Address - Fax:
Practice Address - Street 1:575 S CHARLES ST STE 140
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-2477
Practice Address - Country:US
Practice Address - Phone:443-743-7184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-15
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health