Provider Demographics
NPI:1285079152
Name:BROWN, COROLINE LOUISE (RN)
Entity type:Individual
Prefix:MS
First Name:COROLINE
Middle Name:LOUISE
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6401 DORCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-5101
Mailing Address - Country:US
Mailing Address - Phone:843-207-3019
Mailing Address - Fax:843-207-3084
Practice Address - Street 1:6401 DORCHESTER RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29418-5101
Practice Address - Country:US
Practice Address - Phone:843-207-3019
Practice Address - Fax:843-207-3084
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19354163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool