Provider Demographics
NPI:1306117221
Name:RHONDA G. BROWN
Entity type:Organization
Organization Name:RHONDA G. BROWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:MS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:843-251-2866
Mailing Address - Street 1:6434 SOMERSBY DR
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-8936
Mailing Address - Country:US
Mailing Address - Phone:843-251-2866
Mailing Address - Fax:843-236-5088
Practice Address - Street 1:6434 SOMERSBY DR
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-8936
Practice Address - Country:US
Practice Address - Phone:843-251-2866
Practice Address - Fax:843-236-5088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN-1744163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP0721Medicaid