Provider Demographics
NPI:1053088690
Name:BROWN, ROYALE (MSN, APRN, AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:ROYALE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSN, APRN, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3325
Mailing Address - Country:US
Mailing Address - Phone:304-208-5213
Mailing Address - Fax:
Practice Address - Street 1:300 CARRERA DR
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-6303
Practice Address - Country:US
Practice Address - Phone:606-260-8962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0030255363LA2200X, 363LG0600X, 363LP2300X
WV110463363LA2200X, 363LG0600X, 363LP2300X
KY498871363LA2200X, 363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology