1790547388 NPI number — ABIGAIL LYN BROWN APRN

Table of content: ABIGAIL LYN BROWN APRN (NPI 1790547388)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790547388 NPI number — ABIGAIL LYN BROWN APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
ABIGAIL
Provider Middle Name:
LYN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DAWBER
Provider Other First Name:
ABIGAIL
Provider Other Middle Name:
LYN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1790547388
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8 SHAWMUT AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANFORD
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04073-3956
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
774-277-0058
Provider Business Mailing Address Fax Number:
207-910-6577

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 MARKET PLACE DR STE 1-2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
03909-1698
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-630-2922
Provider Business Practice Location Address Fax Number:
207-805-7970
Provider Enumeration Date:
01/29/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  CNP241016 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)