Healthcare Provider Details

I. General information

NPI: 1699008375
Provider Name (Legal Business Name): ELAINE BROWN GOLDSTONE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2009
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 W HILL ST
DECATUR GA
30030-4367
US

IV. Provider business mailing address

317 W HILL ST
DECATUR GA
30030-4367
US

V. Phone/Fax

Practice location:
  • Phone: 404-482-2048
  • Fax:
Mailing address:
  • Phone: 404-482-2048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF337687
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number012815
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: