Charlene Brown

Individual provider Active NPI Women's Health Nurse Practitioner · Philadelphia, PA

NPI 1851453633 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1851453633
Entity type
Individual (NPI type 1)
Primary specialty
Women's Health Nurse Practitioner 363LW0102X
License
SP 001665 G (PA)
Practice address
1720 South Broad Street
City of Philadelphia Health Department
Philadelphia, PA 19145
Phone
(215) 685-1811
Fax
(215) 683-1815
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SP 001665 GPAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City of Philadelphia Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X SP 001665 G PA Yes

Addresses

Primary practice location

1720 South Broad Street
City of Philadelphia Health Department
Philadelphia, PA 19145

Mailing address

1445 70TH Ave
B-1
Philadelphia, PA 19126-1661
Phone (215) 924-9852

Other identifiers

IdentifierTypeStateIssuer
SP 001665 GOtherPALICENSE NUMBER

Other providers in Philadelphia, PA

All providers in Philadelphia, PA · Women's Health Nurse Practitioner in Pennsylvania

Sources for this page

Verify at the official NPI Registry.