Healthcare Provider Details

I. General information

NPI: 1093313702
Provider Name (Legal Business Name): AMBER ROSE BROWN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 US HIGHWAY 17 STE 500
RICHMOND HILL GA
31324-8877
US

IV. Provider business mailing address

3801 US HWY 17 STE500 PMB1000
RICHMOND HILL GA
31324
US

V. Phone/Fax

Practice location:
  • Phone: 912-321-4028
  • Fax:
Mailing address:
  • Phone: 912-321-4028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN267673
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: