Healthcare Provider Details

I. General information

NPI: 1659810935
Provider Name (Legal Business Name): STEPHANIE GALE BROWN CPNP-PC, NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. STEPHANIE GALE DAVIS

II. Dates (important events)

Enumeration Date: 02/19/2017
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

677 CHURCH ST NE
MARIETTA GA
30060-1101
US

IV. Provider business mailing address

130 BROWN CT
BALL GROUND GA
30107-4952
US

V. Phone/Fax

Practice location:
  • Phone: 678-859-8441
  • Fax:
Mailing address:
  • Phone: 678-859-8441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberRN160287
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN160287
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: