Healthcare Provider Details
I. General information
NPI: 1649826157
Provider Name (Legal Business Name): EMILY JARRETT BROWN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/12/2019
Last Update Date: 01/17/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1120 15TH ST
AUGUSTA GA
30912-4645
US
IV. Provider business mailing address
1120 15TH ST # OR6000
AUGUSTA GA
30912-0004
US
V. Phone/Fax
- Phone: 706-721-6238
- Fax: 706-721-1459
- Phone: 706-721-3813
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 11002873 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | RN232764 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: