Provider Demographics
NPI:1346863537
Name:BROWN, SHEILA LOVE (AGNP)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:LOVE
Last Name:BROWN
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 COTTON CREEK RD
Mailing Address - Street 2:
Mailing Address - City:STAR
Mailing Address - State:NC
Mailing Address - Zip Code:27356-7954
Mailing Address - Country:US
Mailing Address - Phone:910-492-4646
Mailing Address - Fax:910-226-7432
Practice Address - Street 1:103 COTTON CREEK RD
Practice Address - Street 2:
Practice Address - City:STAR
Practice Address - State:NC
Practice Address - Zip Code:27356-7954
Practice Address - Country:US
Practice Address - Phone:910-492-4646
Practice Address - Fax:910-226-7432
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-21
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013188363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty