Provider Demographics
NPI:1710105697
Name:BROWN-SMALL, VANIA LOUISA (APRN, BC)
Entity type:Individual
Prefix:MS
First Name:VANIA
Middle Name:LOUISA
Last Name:BROWN-SMALL
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GOULD ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-2102
Mailing Address - Country:US
Mailing Address - Phone:940-435-9007
Mailing Address - Fax:
Practice Address - Street 1:513 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-1471
Practice Address - Country:US
Practice Address - Phone:401-324-5780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2025-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223556273R00000X
RIAPRN04460364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX612970Medicare PIN