Healthcare Provider Details

I. General information

NPI: 1720046782
Provider Name (Legal Business Name): HENRY T BROWN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 5TH ST SE SOMNUS ANESTHESIA, INC
CAIRO GA
39828-3142
US

IV. Provider business mailing address

PO BOX 611
CAIRO GA
39828-0611
US

V. Phone/Fax

Practice location:
  • Phone: 229-225-8017
  • Fax:
Mailing address:
  • Phone: 229-225-8017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN-CRNA141389
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: