Provider Demographics
NPI:1063421568
Name:BROWN, DEBORAH JEAN (PA)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:JEAN
Last Name:BROWN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8496 WILDERNESS HWY
Mailing Address - Street 2:
Mailing Address - City:NALLEN
Mailing Address - State:WV
Mailing Address - Zip Code:26680-4024
Mailing Address - Country:US
Mailing Address - Phone:304-438-6586
Mailing Address - Fax:
Practice Address - Street 1:75 AVENUE B
Practice Address - Street 2:
Practice Address - City:RICHWOOD
Practice Address - State:WV
Practice Address - Zip Code:26261-1236
Practice Address - Country:US
Practice Address - Phone:304-846-2573
Practice Address - Fax:304-846-9562
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV01199363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant