Provider Demographics
NPI:1861810475
Name:BROWN, MARTHA JULIET (RN)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:JULIET
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 N FIRETOWER RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-9028
Mailing Address - Country:US
Mailing Address - Phone:843-661-4762
Mailing Address - Fax:
Practice Address - Street 1:832 N FIRETOWER RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-9028
Practice Address - Country:US
Practice Address - Phone:843-661-4762
Practice Address - Fax:843-661-4774
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-01
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC47054163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management