Healthcare Provider Details

I. General information

NPI: 1174142236
Provider Name (Legal Business Name): CRYSTAL LYNN BROWNE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7727 LAKE UNDERHILL RD
ORLANDO FL
32822-8224
US

IV. Provider business mailing address

1312 FALLING STAR LN
ORLANDO FL
32828-7495
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-8110
  • Fax:
Mailing address:
  • Phone: 239-269-1294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11006863
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0039829
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4042987
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: