# TERRI BROWN SA-C

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962681809
- **Authorized official:** MISS TERRI LENELLE BROWN (SA-C)
- **Authorized official phone:** (804) 862-2975

## Contact information

- **Practice address:** 59 IVY LN, PETERSBURG, VA 23805-1364
- **Practice address phone:** (804) 862-2975
- **Mailing address:** 59 IVY LN, PETERSBURG, VA 23805-1364
- **Mailing address phone:** (804) 862-2975

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | 07-258 | VA | Yes |

## Other

- **Enumeration date:** 10/28/2007
- **Last updated:** 10/28/2007