Individual
JUANITA ANN BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 FAIRCHILD CT, HAMPTON, VA 23666-6028
(757) 332-6000
(757) 262-1278
Mailing address
4 FAIRCHILD CT, HAMPTON, VA 23666-6028
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82-1285914
—
VA
Enumeration date
11/14/2017
Last updated
11/14/2017
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