MEDICARE: MRS. MARTHA PATTON BROWN R.N.

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	163WC1500X	Community Health Registered Nurse	RN0000027390	TN

General Provider Information

NPI Number	:	1780723171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARTHA PATTON BROWN R.N.

Provider Business Mailing Address
First Line	:	1911 FAIRWAY DR
Second Line	:	1233 SOUTHWEST AVE
City	:	JOHNSON CITY
State	:	TN
Zip	:	37601
Country	:	US
Telephone Number	:	423-928-4479
Fax Number	:

Provider Business Practice Location Address
First Line	:	1911 FAIRWAY DR
Second Line	:	1233 SOUTHWEST AVE
City	:	JOHNSON CITY
State	:	TN
Zip	:	37601-2264
Country	:	US
Telephone Number	:	423-928-4479
Fax Number	:

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

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	07/08/2007

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