Individual
MS. SUZANNE LEE BROWN
Active
Individual
MS. SUZANNE LEE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
00765
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001719255
MOUNTAIN STATE BCBS
WV
01
—
P00328097
RAILROAD MEDICARE
WV
01
—
WV765
HEALTH PLAN
WV
Enumeration date
07/19/2006
Last updated
06/17/2021
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