Provider Demographics
NPI:1528074598
Name:BROWN, RACHEL (BS, PT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:BS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 639
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27331-0639
Mailing Address - Country:US
Mailing Address - Phone:919-353-4499
Mailing Address - Fax:
Practice Address - Street 1:1456 CAROLINA DR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27332-7341
Practice Address - Country:US
Practice Address - Phone:919-353-4499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2908225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211179Medicaid