Provider Demographics
NPI:1801977277
Name:BROWN, LINDA BONGIORNO (MSN,RN,CS,FNP)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:BONGIORNO
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSN,RN,CS,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 N BOUNDARY ST
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-3701
Mailing Address - Country:US
Mailing Address - Phone:919-942-6905
Mailing Address - Fax:
Practice Address - Street 1:140 MAIN ST.
Practice Address - Street 2:
Practice Address - City:PROSPECT HILL
Practice Address - State:NC
Practice Address - Zip Code:27314
Practice Address - Country:US
Practice Address - Phone:336-562-3311
Practice Address - Fax:336-562-4444
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC067541363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCS54001Medicare ID - Type Unspecified