MEDICARE: DIANA BROWN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	189567	TN

General Provider Information

NPI Number	:	1336091735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA BROWN RN

Provider Business Mailing Address
First Line	:	681 S WHITE STATION RD STE 103
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38117-4561
Country	:	US
Telephone Number	:	901-969-1531
Fax Number	:	888-615-1445

Provider Business Practice Location Address
First Line	:	681 S WHITE STATION RD STE 103
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38117-4561
Country	:	US
Telephone Number	:	901-969-1531
Fax Number	:	888-615-1445

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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