Healthcare Provider Details

I. General information

NPI: 1013395847
Provider Name (Legal Business Name): DANIELLE BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2015
Last Update Date: 05/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 MAIN ST
PERRY GA
31069-3533
US

IV. Provider business mailing address

1218 MAIN ST
PERRY GA
31069-3533
US

V. Phone/Fax

Practice location:
  • Phone: 478-224-9655
  • Fax: 478-224-5228
Mailing address:
  • Phone: 478-224-9655
  • Fax: 478-224-5228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2470A2800X
TaxonomyAssistant Health Information Record Technician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: