Individual
MALISSA RENE BROWN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
N.P
Contact information
Practice address
200 PATEWOOD DR, SUITE A14, GREENVILLE, SC 29615-3593
(864) 454-2226
Mailing address
255 ENTERPRISE BLVD, SUITE 102, GREENVILLE, SC 29615-6300
(864) 454-1142
(864) 454-1144
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2449
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57-6007863106
BCBS OF SC
SC
05
—
NP0359
—
SC
Enumeration date
05/16/2006
Last updated
11/05/2021
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