Healthcare Provider Details

I. General information

NPI: 1912371782
Provider Name (Legal Business Name): RENEE BATEMAN BROWN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2015
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

488 KENNESAW AVE NW STE 200
MARIETTA GA
30060
US

IV. Provider business mailing address

1355 PEACHTREE ST NE STE 1600
ATLANTA GA
30309-3276
US

V. Phone/Fax

Practice location:
  • Phone: 770-427-3075
  • Fax: 770-427-3261
Mailing address:
  • Phone: 678-223-7774
  • Fax: 678-223-7799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-NP128854
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: