Healthcare Provider Details

I. General information

NPI: 1710222450
Provider Name (Legal Business Name): CYNTHIA M. BROWN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA M. BROWN. RN,CNSPMH, ANP

II. Dates (important events)

Enumeration Date: 12/06/2012
Last Update Date: 12/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 PEACHTREE ST., N.W. SUITE 77 MHM,
ATLANTA GA
30303
US

IV. Provider business mailing address

2212 OAKGROVE CIR
VALDOSTA GA
31602-2203
US

V. Phone/Fax

Practice location:
  • Phone: 800-729-1601
  • Fax:
Mailing address:
  • Phone: 229-244-4142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN038371
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN038371
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN038371
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: