MEDICARE: OMEGA SHANTA BROWN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	314620	GA

General Provider Information

NPI Number	:	1396607826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OMEGA SHANTA BROWN

Provider Business Mailing Address
First Line	:	73 HARMONY CREEK DR
Second Line	:
City	:	HIRAM
State	:	GA
Zip	:	30141-2613
Country	:	US
Telephone Number	:	239-634-7149
Fax Number	:

Provider Business Practice Location Address
First Line	:	73 HARMONY CREEK DR
Second Line	:
City	:	HIRAM
State	:	GA
Zip	:	30141-2613
Country	:	US
Telephone Number	:	239-634-7149
Fax Number	:

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

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

Similar Medicare Providers

1306732938 — TRINITY SURGICAL LLC
Practice Location Address:

277 COVINGTON DR
HIRAM, GA
30141-2257

Practice Phone: 757-287-8914
Practice Fax:

1871049510 — MISS STEPHANIE MARIE BULLOCK CSA
Practice Location Address:

277 COVINGTON DR
HIRAM, GA
30141-2257

Practice Phone: 757-287-8914
Practice Fax: 844-550-4221

1952265183 — RENEWED PATHWAYS LLC.
Practice Location Address:

6736 BILL CARRUTH PKWY
HIRAM, GA
30141-3786

Practice Phone: 470-728-6147
Practice Fax:

1942162458 — TAWANA TARBEART
Practice Location Address:

5745 WENDY BAGWELL PKWY STE 25
HIRAM, GA
30141-2885

Practice Phone: 678-400-7771
Practice Fax:

1215890587 — SHANTEL DENNIS
Practice Location Address:

538 KYLES CIR
HIRAM, GA
30141-4699

Practice Phone: 404-796-1889
Practice Fax:

1467741553 — DAVID CHARLES GIBSON DO
Practice Location Address:

2518 JIMMY LEE SMITH PKWY
HIRAM, GA
30141-2068

Practice Phone: 470-644-7000
Practice Fax:

Directions to “ OMEGA SHANTA BROWN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.