Provider Demographics
NPI:1447656921
Name:BROWN, FOLASHADE
Entity type:Individual
Prefix:
First Name:FOLASHADE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 AMBER MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1588
Mailing Address - Country:US
Mailing Address - Phone:301-218-5402
Mailing Address - Fax:
Practice Address - Street 1:2150 PENNSYLVANIA AVE NW STE 8-416
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037
Practice Address - Country:US
Practice Address - Phone:202-741-2227
Practice Address - Fax:201-741-2637
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-11
Last Update Date:2018-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR125416363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily