Healthcare Provider Details

I. General information

NPI: 1437305752
Provider Name (Legal Business Name): SHERIDA L BROWN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 10/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 PEACHTREE ST 450
ATLANTA GA
30309
US

IV. Provider business mailing address

2678 BUFORD HWY NE
ATLANTA GA
30324-3240
US

V. Phone/Fax

Practice location:
  • Phone: 678-904-5999
  • Fax: 678-904-5998
Mailing address:
  • Phone: 678-904-5999
  • Fax: 678-904-5998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberRN045651
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: