Look up the most recent NPI and PECOS records

Brandy Latisha Brown

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

This provider is enrolled in PECOS as BRANDY BROWN.

Based on the most recent information from CMS, provider Brandy Latisha Brown is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:59 PM.

Profile Details

Provider ID
1366073009
Provider Type
Individual
Full Name
Brown, Brandy Latisha
Credential
FNP

Gender
Female
Sole Proprietor
Yes
Enumeration Date
1/31/2020
Last Updated
3/27/2024

Contact Information

Practice Location

200 Queens Rd, Charlotte, NC 28204-3253

(704) 372-4563

Unlisted Fax

Mailing Location

200 Queens Rd, Charlotte, NC 28204-3253

(704) 372-4563

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 5012854 North Carolina
Code 363L00000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 5012854 North Carolina

Brandy Latisha Brown

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Thompson, Desirea'

Smith, Lisa Kathryn

Tibolla, Necole Antoinette

Hurley, Susie

Takon, Lovina;

Palmer, Scott Mikael

Lambert, Eleanor W.

Mpofu, Fikile Sithembiso

Brigman, Lester

Jones, Stephanie Marie