Individual
EBONY NICOLE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA EXP PSYCHOLOGY RN
Contact information
Practice address
250 DEWEY AVE, SPARTANBURG, SC 29303-3009
(864) 585-0366
(864) 585-9208
Mailing address
250 DEWEY AVE, SPARTANBURG, SC 29303-3009
(864) 585-0366
(864) 585-9208
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
106396
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427168889
—
SC
Enumeration date
12/06/2006
Last updated
09/18/2008
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